Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: A systematic literature review for the 2019 update of EULAR recommendations
Rondaan, Christien; Furer, Victoria; Heijstek, Marloes W.; Agmon-Levin, Nancy; Bijl, Marc; Breedveld, Ferdinand C.; D'Amelio, Raffaele; Dougados, Maxime; Kapetanovic, Meliha C.; Van Laar, Jacob M.; De Thurah, Annette Ladefoged; Landewé, Robert; Molto, Anna; Müller-Ladner, Ulf; Schreiber, Karen; Smolar, Leo; Walker, Jim; Warnatz, Klaus; Wulffraat, Nico M.; Van Assen, Sander; Elkayam, Ori
(2019) RMD Open, volume 5, issue 2
(Article)
Abstract
Aim To present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating the EULAR evidence-based recommendations. Methods An SLR was performed according to the standard operating procedures for EULAR-endorsed recommendations. Outcome
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was determined by efficacy, immunogenicity and safety of vaccination in adult patients with AIIRD, including those receiving immunomodulating therapy. Furthermore, a search was performed on the effect of vaccinating household members of patients with AIIRD on the occurrence of vaccine-preventable infections in patients and their household members (including newborns). The literature search was performed using Medline, Embase and the Cochrane Library (October 2009 to August 2018). Results While most investigated vaccines were efficacious and/or immunogenic in patients with AIIRD, some were less efficacious than in healthy control subjects, and/or in patients receiving immunosuppressive agents. Adverse events of vaccination were generally mild and the rates were comparable to those in healthy persons. Vaccination did not seem to lead to an increase in activity of the underlying AIIRD, but insufficient power of most studies precluded arriving at definite conclusions. The number of studies investigating clinical efficacy of vaccination is still limited. No studies on the effect of vaccinating household members of patients with AIIRD were retrieved. Conclusion Evidence on efficacy, immunogenicity and safety of vaccination in patients with AIIRD was systematically reviewed to provide a basis for updated recommendations.
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Keywords: autoimmune diseases, infections, vaccination, Rheumatology, Immunology and Allergy, Immunology, Journal Article
ISSN: 2056-5933
Publisher: BMJ Publishing Group
Note: Funding Information: this project was supported by eUlar. Funding Information: Competing interests KW reports personal fees from Pfizer, during the conduct of the study; grants and personal fees from Biotest, cSl Behring, personal fees from lFB, grifols, Baxter, roche, Octapharma, grants from BMS, outside the submitted work. aM reports grants and personal fees from aBBVie, Pfizer, BMS, UcB, MercK, during the conduct of the study. MD reports grants and personal fees from PFiZer, aBBVie, UcB, nOVartiS, lillY, MercK, rOcHe, grants from BMS, outside the submitted work. Oe reports grants and personal fees from Pfizer, abbvie, roche, Janssen, personal fees from novartis and lilly. all other authors have no conflicts of interests to declare. Publisher Copyright: © 2019 Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
(Peer reviewed)
