50483 Hepatitis B Vaccine Response in Psoriasis: Assessing the Impact of Immunosuppressive Treatments

Biologic and systemic immunosuppressive therapies have significantly enhanced the treatment of psoriasis. However, these treatment modalities increase the risk of infections, notably hepatitis B virus (HBV), among patients. It is unclear how the immunogenicity of the HBV vaccination is affected in psoriasis patients on immunosuppressive therapies. We conducted a cross-sectional retrospective chart review of 71 adult patients with moderate-to-severe psoriasis who initially lacked immunity to HBV and later received at least one dose of the HBV vaccine. Before HBV vaccination, thirty-eight patients were initiated on some form of immunosuppressive therapy, with 28 patients on biologic monotherapy and 10 on a biologic combined with a disease-modifying antirheumatic drug [DMARD]. The post-vaccination HBV surface antibody (HBsAb) levels among patients on and off any immunosuppressive therapy (median 72.0IU/L vs. 28.3IU/L); were found to be similar (p=0.35). The percentage of patients with post-vaccination HBsAb levels ≥10IU/L (i.e., the seroprotection rate) (57.9% for those on therapy vs. 60.6% for those off) was also similar (p=0.82). Multivariate analysis revealed lower HBsAb levels among patients on combination therapy when compared to those on no immunosuppressive therapy (p=0.04). There was no difference in the odds of achieving seroprotective levels by immunosuppressive therapy status (any) or type (biologic monotherapy or combination) when compared to none (OR=0.79, OR=1.09, and OR=0.15; p=0.76, p=0.92, and p=0.10, respectively). In conclusion, the efficacy and seroprotection rates following HBV vaccination are consistent among psoriasis patients, irrespective of their therapy status or type, suggesting flexibility in vaccination timing for non-immune patients after starting therapy.