Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners
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. Immunizatio...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2015-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/5972/14147_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PF2(AGAK).pdf |
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| author | Piyush Ranjan Avinash Chakrawarty Archana Kumari Jitendra Kumar |
| author_facet | Piyush Ranjan Avinash Chakrawarty Archana Kumari Jitendra Kumar |
| author_sort | Piyush Ranjan |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-18T19:42:10Z |
| format | Article |
| id | doaj.art-feb3eb32191547798d3439bf25021499 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-18T19:42:10Z |
| publishDate | 2015-05-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-feb3eb32191547798d3439bf250214992022-12-21T20:55:25ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-05-0195OE01OE0410.7860/JCDR/2015/14147.5972Immunization in Patients with Rheumatic Diseases: A Practical Guide for General PractitionersPiyush Ranjan0Avinash Chakrawarty1Archana Kumari2Jitendra Kumar3Assistant Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.Assistant Professor, Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India.Assistant Professor, Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India.Senior Resident, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India.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.https://jcdr.net/articles/PDF/5972/14147_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PF2(AGAK).pdfimmunosuppressive drugslive vaccinessteroids |
| spellingShingle | Piyush Ranjan Avinash Chakrawarty Archana Kumari Jitendra Kumar Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners Journal of Clinical and Diagnostic Research immunosuppressive drugs live vaccines steroids |
| title | Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners |
| title_full | Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners |
| title_fullStr | Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners |
| title_full_unstemmed | Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners |
| title_short | Immunization in Patients with Rheumatic Diseases: A Practical Guide for General Practitioners |
| title_sort | immunization in patients with rheumatic diseases a practical guide for general practitioners |
| topic | immunosuppressive drugs live vaccines steroids |
| url | https://jcdr.net/articles/PDF/5972/14147_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PF2(AGAK).pdf |
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