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2015 ; 9
(5
): OE01-4
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Immunization in Patients with Rheumatic Diseases: A Practical Guide for General
Practitioners
#MMPMID26155514
Ranjan P
; Chakrawarty A
; Kumari A
; Kumar J
J Clin Diagn Res
2015[May]; 9
(5
): OE01-4
PMID26155514
show ga
Patients with rheumatic diseases are susceptible to various infections throughout
the course of the disease. The increased risk of infections can be attributed
partly to the aberrant immune system and partly to the effect of
immunosuppressive drugs used in the treatment of the disease. Immunization
appears to be an excellent strategy to prevent infections in such patients.
However, the effect of vaccines in these patients is modified due to disease per
se and/or immunosuppressive drugs. Biological agents, that frequently increase
the susceptibility to infections, are now being initiated earlier in the course
of the disease and also for new indications. Thus, concerns regarding safety,
efficacy and potential adverse effects of vaccines in these patients are more
complex than in any other immunosuppressive conditions. Different patients show
different amount of immunosuppression in response to disease modifying drugs.
Besides, there is lack of adequately powered randomised controlled trials
investigating the efficacy of a vaccine in terms of actual prevention of the
disease. Pneumococcal and influenza vaccines are the most studied vaccines and
they are strongly recommended in rheumatic patients. In general, live vaccines
should be avoided among patients receiving high doses of immunosuppressive drugs.
However, they may be given to patients receiving low dose steroids and
methotrexate. Non-live vaccines may be administered as per the recommendations of
national guidelines. There is necessity to increase awareness among patients and
doctors towards promoting the appropriate and judicious use of vaccines in the
patients with rheumatic diseases.