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Title: A practical approach to vaccination of patients with autoimmune inflammatory rheumatic diseases in Australia.
Austin Authors: Wong, Peter K K;Bagga, Hanish;Barrett, Claire;Hanrahan, Paddy;Johnson, Douglas F;Katrib, Amel;Leder, Karin;Marabani, Mona;Pentony, Peta;Riordan, John;White, Ray;Young, Laurel
Affiliation: Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia
UNSW Rural Clinical School, Coffs Harbour, New South Wales, Australia
Private Rheumatology Practice, South Perth, Western Australia, Australia
Faculty of Medicine, University of Western Australia, South Perth, Western Australia, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Rheumatology, Prince of Wales Hospital, Sydney, New South Wales, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Institute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
Illawarra Rheumatology and University of Wollongong Graduate School of Medicine, Wollongong, New South Wales, Australia
Private Rheumatology Practice, Sydney, New South Wales, Australia
Department of Rheumatology, Redcliffe Hospital, Brisbane, Queensland, Australia
Redcliffe Northside Rheumatology, Brisbane, Queensland, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Issue Date: May-2017
Publication information: Internal Medicine Journal 2017; 47(5): 491-500
Abstract: Autoimmune inflammatory rheumatic diseases (AIIRD), such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities and the use of immunosuppressive conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) and more recently, targeted synthetic DMARDs and biologic DMARDs that block specific pro-inflammatory enzymes, cytokines or cell types. The use of these various DMARDs has revolutionised the treatment of AIIRD. This has led to a marked improvement in quality of life for AIIRD patients, who often now travel for prolonged periods. Many infections are preventable with vaccination. However, as protective immune responses induced by vaccination may be impaired by immunosuppression, where possible, vaccination may need to be performed prior to initiation of immunosuppression. Vaccination status should also be reviewed when planning overseas travel. Limited data regarding vaccine efficacy in patients with AIIRD make prescriptive guidelines difficult. However, a vaccination history should be part of the initial work-up in all AIIRD patients. Those caring for AIIRD patients should regularly consider vaccination to prevent infection within the practicalities of routine clinical practice.
DOI: 10.1111/imj.13371
PubMed URL: 28101910
Type: Journal Article
Subjects: biologics
rheumatic disease
Appears in Collections:Journal articles

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