Do SMS/e-mail reminders increase influenza vaccination of rheumatoid arthritis patients under anti-TNF: a nested randomized controlled trial in the ART e-cohort

Yann Nguyen; Gabriel Baron; Naima Hamamouche; Rakiba Belkhir; Sylvie Miconnet; Martin Soubrier; Camille Hostachy; Pascale Thevenot; André Basch; Marie-Elise Truchetet; Pascal Claudepierre; Emmanuelle Dernis; Hubert Marotte; René-Marc Flipo; Olivier Brocq; Jacques Morel; Bruno Fautrel; Carine Salliot; Alain Saraux; Charles Leske; Thierry Schaeverbeke; Philippe Ravaud; Xavier Mariette; Adeline Ruyssen-Witrand; Raphaèle Seror; ART study group

doi:10.1093/rheumatology/keae599

Do SMS/e-mail reminders increase influenza vaccination of rheumatoid arthritis patients under anti-TNF: a nested randomized controlled trial in the ART e-cohort

Rheumatology (Oxford). 2024 Nov 22:keae599. doi: 10.1093/rheumatology/keae599. Online ahead of print.

Authors

Yann Nguyen^{1

2}, Gabriel Baron³, Naima Hamamouche⁴, Rakiba Belkhir¹, Sylvie Miconnet¹, Martin Soubrier⁵, Camille Hostachy¹, Pascale Thevenot⁶, André Basch⁷, Marie-Elise Truchetet⁸, Pascal Claudepierre⁹, Emmanuelle Dernis¹⁰, Hubert Marotte¹¹, René-Marc Flipo¹², Olivier Brocq¹³, Jacques Morel¹⁴, Bruno Fautrel¹⁵, Carine Salliot¹⁶, Alain Saraux¹⁷, Charles Leske¹⁸, Thierry Schaeverbeke¹⁹, Philippe Ravaud³, Xavier Mariette^{1

2}, Adeline Ruyssen-Witrand^{2

1}, Raphaèle Seror^{1

2}; ART study group

Affiliations

¹ Department of Rheumatology and National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Bicêtre, Université Paris-Saclay, Le Kremlin Bicêtre, France.
² INSERM UMR1184, Le Kremlin Bicêtre, France.
³ Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP), Paris, France.
⁴ SANOIA Health Service, Gémenos, France.
⁵ Rheumatology Department, University Hospital, Clermont-Ferrand, France.
⁶ French Rheumatology Society, Paris, France.
⁷ Infirmerie Protestante de Lyon, Caluire et Cuire, Lyon, France.
⁸ Rheumatology Department, Bordeaux University Hospital, Bordeaux, France.
⁹ Rheumatology Department, Hopital Henri-Mondor, AP-HP, EpiDermE, Université Paris Est Créteil, Creteil, France.
¹⁰ Rheumatology Department, CH Le Mans, Le Mans, Pays de la Loire, France.
¹¹ Service de Rhumatologie, CHU Saint-Étienne, Université Jean Monnet Saine-Étienne, CIC-1408, Mines Saint-Etienne, INSERM, Saint-Etienne, SAINBIOSE U1059, France.
¹² Rheumatology Department, Université Lille, CHU Lille, Lille, France.
¹³ Rheumatology Department, Centre Hospitalier Princesse Grace, Monaco Monaco.
¹⁴ Department of Rheumatology, CHU Montpellier (Montpellier University Hospital Centre), Montpellier University, Montpellier, France.
¹⁵ Department of Rheumatology, AP-HP, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
¹⁶ Department of Rheumatology, Centre Hospitalier Régional d'Orléans, Orléans, France.
¹⁷ Lymphocytes B et Autoimmunité Université de Brest, Inserm 1227, CHU Brest, Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINO) (National Reference Centre for Rare Auto-Immune Diseases), CHU, Brest, France.
¹⁸ Department of Rheumatology, CH de Cholet, Cholet, France.
¹⁹ Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Groupe Hospitalier, Pellegrin, Bordeaux, France.

PMID: 39576675
DOI: 10.1093/rheumatology/keae599

Abstract

Objectives: To evaluate the effectiveness of short message service (SMS) and/or email reminders in improving influenza vaccination coverage rates among rheumatoid arthritis (RA) patients treated with anti-TNF therapies, and to identify factors associated with vaccination.

Methods: A nested randomized controlled trial in the ART e-cohort, an ongoing French nationwide multicentre prospective cohort of RA patients treated with anti-TNF therapy. Patients were 1:1 randomized, with stratification on age. The intervention consisted in regular reminders via SMS and/or emails to get vaccinated against influenza during the vaccination campaign. After the end, all participants received a questionnaire. The primary outcome was the influenza vaccination coverage. Secondary outcomes included the vaccination coverage before and after COVID-19 pandemic, and factors associated with vaccination.

Results: Between October 2021 and April 2022, 446 participants were randomized (224 in the intervention group, 222 in the control group). Among them, 325 (73%) reported their vaccination status and 221 (68%) were vaccinated against influenza: 116/158 (73%) in the intervention group, vs 105/167 (63%) in the control group (RR 1.08; 95% CI 0.95-1.23). The vaccination coverage before and after COVID-19 pandemic did not differ (72% vs 72%; 95% CI -8% to8%). Age ≥65 years (OR 6.25; 95% CI 2.88-13.60), and previous influenza vaccination in the years before inclusion (OR 7.81; 95% CI 4.36-14.02) were associated with higher rates of vaccination.

Conclusion: SMS and/or e-mails reminders did not significantly improve influenza vaccination rates in our cohort. COVID-19 pandemic did not substantially impact the influenza vaccination coverage. Our results might be counterbalanced by an already high vaccination coverage.

Trial registration number: www.clinicaltrials.gov; NCT05220423; NCT03062865.

Keywords: Rheumatoid arthritis; bDMARDs; influenza; vaccine.

Associated data

ClinicalTrials.gov/NCT05220423
ClinicalTrials.gov/NCT03062865