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Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology

2016-03-18Journal article Open access
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dc.contributor.authorCordeiro, I
dc.contributor.authorDuarte, AC
dc.contributor.authorFerreira, J
dc.contributor.authorGonçalves, MJ
dc.contributor.authorMeirinhos, T
dc.contributor.authorRocha, T
dc.contributor.authorRomão, V
dc.contributor.authorSousa, S
dc.contributor.authorGuedes, M
dc.contributor.authorConde, M
dc.contributor.authorAbreu, C
dc.contributor.authorAleixo, MJ
dc.contributor.authorSantos, MJ
dc.date.accessioned2016-05-10T13:37:29Z
dc.date.available2016-05-10T13:37:29Z
dc.date.issued2016-03-18
dc.description.abstractSerious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients. OBJECTIVES: To develop evidence-based recommendations for vaccination in SIRD patients. METHODS: We searched MEDLINE (until 31 October 2014) and EMBASE (until 14 December 2014) databases, as well as the ACR and EULAR congress abstracts (2011-2014). Patients with any systemic inflammatory rheumatic disease were included and all vaccines were considered. Any safety and efficacy outcomes were admitted. Search results were submitted to title and abstract selection, followed by detailed review of suitable studies. Data were subsequently pooled according to the type of vaccine and the SIRD considered. Results were presented and discussed by a multidisciplinary panel and systematic literature review (SLR)-derived recommendations were voted according to the Delphi method. The level of agreement among rheumatologists was assessed using an online survey. RESULTS: Eight general and seven vaccine-specific recommendations were formulated. Briefly, immunization status should routinely be assessed in all SIRD patients. The National Vaccination Program should be followed and some additional vaccines are recommended. To maximize the efficacy of vaccination, vaccines should preferably be administered 4 weeks before starting immunosuppression or, if possible when disease activity is controlled. Non-live vaccines are safe in SIRD, including immunosuppressed patients. The safety of live attenuated vaccines in immunosuppressed patients deserves further ascertainment, but might be considered in particular situations. DISCUSSION: The present recommendations combine scientific evidence with the multidisciplinary expertise of our taskforce panel and attained desirable agreement among Portuguese rheumatologists. Vaccination recommendations need to be updated on a regular basis, as more scientific data regarding vaccination efficacy and safety, emergent infectious threats, new vaccines as well as new immunomodulatory therapies become available.pt_PT
dc.identifier.citationActa Reumatol Port. 2016 Mar 18. [Epub ahead of print]pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2476
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Reumatologiapt_PT
dc.subjectAntirheumatic agentspt_PT
dc.subjectImmunosuppressive agentspt_PT
dc.subjectRheumatic diseasespt_PT
dc.subjectVaccinationpt_PT
dc.subjectAdultpt_PT
dc.subjectHDE REUM PEDpt_PT
dc.titleRecommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatologypt_PT
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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