我们应该在活跃的风湿性疾病期间接种疫苗吗?
Marc Bijl1, Johanna Westra2, Silvia Mancuso3
1Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, the Netherlands.
Autoimmunity reviews
|August 27, 2023
概括
在疾病静止期间接种自身免疫性炎症性类风湿病 (AIIRD) 患者的疫苗可以最大限度地提高疫苗的有效性. 最佳时机考虑免疫抑制疗法,以确保强大的免疫应对感染.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 预防传染病 预防传染病
背景情况:
- 感染是自身免疫性炎症性风湿性疾病 (AIIRD) 的重要风险,增加并发症和死亡率.
- 接种疫苗对AIIRD患者至关重要,但与疾病活性和免疫抑制疗法相比,其时间是有争议的.
- 疫苗的有效性可能受到AIIRD疾病活性和疾病修饰性抗风湿药物 (DMARD) 的影响.
研究的目的:
- 澄清AIIRD患者接种疫苗的最佳时间.
- 评估疾病活性和免疫抑制治疗对疫苗反应的影响.
- 在AIIRD中为疫苗接种策略提供基于证据的建议.
主要方法:
- 对AIIRD患者接种疫苗的现实研究的审查.
- 对影响疫苗免疫性因素的分析,包括疾病活性和DMARDs.
- 考虑EULAR 2019关于在风湿性疾病中接种疫苗的建议.
主要成果:
- 接种疫苗通常不会显著影响AIIRD疾病活动.
- 高度的疾病活性,特别是在系统性红斑狼中,与减少的疫苗反应 (血清转化) 相相关.
- 免疫抑制疗法 (DMARDs) 可以降低疫苗的免疫性.
结论:
- 建议大多数AIIRD患者接种疫苗,最好是在疾病静止期间.
- 建议在启动免疫抑制之前注射疫苗.
- 在接受免疫抑制疗法时,静止疾病期间的疫苗接种为血清转化提供了最佳的窗口,允许安全的药物间隔.
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