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Although we recruited patients with connective tissue diseases in our study, none of the patients included suffered from systemic lupus erythematosus (SLE). As belimumab is a drug approved exclusively for the treatment of SLE and there were no participants with SLE, we were not able to study the behaviour of the vaccine in patients receiving belimumab treatment. The European League Against Rheumatism (EULAR) vaccine recommendations, updated in 2019, include annual influenza vaccination for patients with inflammatory autoimmune diseases receiving immunosuppressive treatments.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These treatments include belimumab, as well as others such as secukinumab, ixekizumab, canakinumab, tofacitinib and baricitinib, which we did not include in our study, either because we did not recruit patients with these therapies during the inclusion period or because at the time of the study, their therapeutic indications had not yet been approved. We fully agree with Callejas JL et al., in the indication to vaccinate annually against influenza in patients under treatment with belimumab. 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Letter to the Editor
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Respuesta
Patricia Richi
, Martina Steiner, Santiago Muñoz-Fernández
Corresponding author
Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain