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Are patients with rheumatic diseases on immunosuppressive therapies protected against preventable infections? A cross-sectional cohort study.
Kiltz, Uta; Celik, Aylin; Tsiami, Styliani; Buehring, Bjoern; Baraliakos, Xenofon; Andreica, Ioana; Kiefer, David; Braun, Juergen.
  • Kiltz U; Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany uta.kiltz@elisabethgruppe.de.
  • Celik A; Ruhr Universität Bochum, Bochum, Germany.
  • Tsiami S; Department of Internal Medicine, Klinikum Westfalen GmbH, Dortmund, Germany.
  • Buehring B; Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany.
  • Baraliakos X; Ruhr Universität Bochum, Bochum, Germany.
  • Andreica I; Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany.
  • Kiefer D; Ruhr Universität Bochum, Bochum, Germany.
  • Braun J; Ruhr Universität Bochum, Bochum, Germany.
RMD Open ; 7(1)2021 04.
Article in English | MEDLINE | ID: covidwho-1175192
ABSTRACT

OBJECTIVE:

To evaluate the prevalence of infections, prevalence of hospitalisation due to infections, the vaccination status and perceived screening of infections prior to the start of biologic disease modifying antirheumatic drugs (bDMARDs) of a patient cohort with chronic inflammatory rheumatic diseases (CIRD).

METHODS:

Consecutive CIRD patients reporting to our specialised centre were prospectively included (n=975) in this cross-sectional study. Data on comorbidities including infections, treatment, vaccination status, screening for latent tuberculosis infection (LTBI) and hepatitis B (HepB) were collected. Antibodies against measles and HepB were measured by ELISA. The vaccination status was assessed by a predefined vaccination score (0-26) categorising patients into four immunisation states low (0-6), moderate (7-13), good (14-20), high (21-26).

RESULTS:

All patients on bDMARDs (n=499) were screened for LTBI, and 469 for HepB (94%). All LTBI patients (n=16) received isoniazid (3.2%) and 16 chronic HepB patients received lamivudine (3.4%). Protective measles specific IgG-antibodies were found in 901 patients (92.4%). Although 629 patients were educated about vaccination strategies (64.5%), only 540 showed a vaccination card (55.4%). Only 49% of patients had undergone pneumococcal vaccination and less than 30% were protected against HepB and influenza, while 7.6% have not protective antibody titres against measles. No patient met the German national vaccination recommendations requiring a complete documentation of vaccines. The mean vaccination score was 13.3±4.2 with 5.7% of patients having a low, 43.9% a moderate, 47.0% a good and 3.3% a high score.

CONCLUSIONS:

The majority of CIRD patients are n0t sufficiently vaccinated against pneumococci, HepB, influenza and measles. Although CIRD patients and general practitioners regularly receive professional information about the need of vaccination, vaccination rates were low to moderate. Interdisciplinary quality projects should be planned to change that inacceptable result.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Hepatitis B Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2020-001499

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Hepatitis B Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2020-001499