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Please use this identifier to cite or link to this item : http://hdl.handle.net/2078.1/32810
Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with immunomodulatory or immunosuppressive drugs. In spite of their elevated risk for vaccine-preventable disease, vaccination coverage in IMID patients is surprisingly low. This review summarizes current literature data on vaccine safety and efficacy in IMID patients treated with immunosuppressive or immunomodulatory drugs and formulates best-practice recommendations on vaccination in this population. Especially in the current era of biological therapies, including TNF-blocking agents, special consideration should be given to vaccination strategies in IMID patients. Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given. Although the reduced quality of the immune response in patients under immunotherapy may have a negative impact on vaccination efficacy in this population, adequate humoral response to vaccination in IMID patients has been demonstrated for hepatitis B, influenza and pneumococcal vaccination. Vaccination status is best checked and updated before the start of immunomodulatory therapy: live vaccines are not contraindicated at that time and inactivated vaccines elicit an optimal immune response in immunocompetent individuals.
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| Publication Date : | 2010 |
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| Document type : | Article de périodique (Journal article) - (Journal Article) |
| Source : | “Rheumatology (Print)” - Vol. 49, no. 10, p. 1815-1827 (2010) |
| Peer-reviewed : |  |
| Publisher : | Oxford University Press ((United Kingdom) Oxford) |
| issn : | 1462-0324 |
| Publication status : | Publié |
| MESH : | Vaccines - adverse effects ; Vaccination - adverse effects ; Risk Factors ; Psoriasis - immunology ; Irritable Bowel Syndrome - immunology ; Inflammatory Bowel Diseases - immunology ; Immunocompromised Host - immunology ; Immunization Schedule ; Humans |
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