scholarly journals Are patients with rheumatic diseases on immunosuppressive therapies protected against preventable infections? A cross-sectional cohort study

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001499
Author(s):  
Uta Kiltz ◽  
Aylin Celik ◽  
Styliani Tsiami ◽  
Bjoern Buehring ◽  
Xenofon Baraliakos ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Pneumococcal Vaccination ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Study Data ◽  
Vaccination Status ◽  
Inflammatory Rheumatic Diseases ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Vaccination Recommendations

ObjectiveTo 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).MethodsConsecutive 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).ResultsAll 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.ConclusionsThe 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.

Satisfaction and Adherence to Biological Treatment in Patients with Rheumatic Diseases

2021 ◽  
Vol 18 ◽  
Author(s):  
Marwa Hammad ◽  
Huny Bakry
Keyword(s):  
Rheumatic Diseases ◽  
Biological Treatment ◽  
Formal Education ◽  
Biological Therapy ◽  
Cross Sectional Study ◽  
P Value ◽  
Inflammatory Rheumatic Diseases ◽  
Cross Sectional ◽  
New Era ◽  
The Mean

Background: Autoimmune inflammatory rheumatic diseases have long been treated by conventional disease-modifying anti-rheumatic drugs. Biological therapy is a new era in the treatment of rheumatic diseases, but satisfaction and adherence to it is still not well tested. Aim: To assess the satisfaction and adherence to biological treatment among patients with autoimmune inflammatory rheumatic diseases. Methods: A cross sectional study was conducted among 56 patients suffering from inflammatory rheumatic diseases using Morisky 8 questionnaire and Treatment Satisfaction Questionnaire for Medication (TSQM) over a period of one month Results: About 76.8% of the patients had medium adherence and the underlying cause of missing doses was the unavailability of the drugs. The mean satisfaction with biological treatment was 62.7±6.9. Patients who did not receive formal education had significantly higher satisfaction with the biological treatment than others 64.94±5.01 at a P value 0.04 (<0.05). Conclusion: Patients with inflammatory rheumatic diseases in our study showed medium adherence and satisfaction. Authorities in the medical field are providing great help to these patients in need of biological therapy, but ensuring the availability of all doses of the biological treatment regimen is still necessary. Patient, family and nurse education programs are also necessary to maximize adherence and satisfaction.

scholarly journals Seasonal Influenza and Pneumococcal Vaccination Rates Among Patients with Cancer in COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 7 (2) ◽  
pp. 64-70
Author(s):  
Emre YEKEDÜZ ◽  
Elif Berna KÖKSOY ◽  
Satı Coşkun YAZGAN ◽  
Ilgın AKBIYIK ◽  
Sevinç BALLI ◽  
...  
Keyword(s):  
Seasonal Influenza ◽  
Pneumococcal Vaccination ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Patients With Cancer

scholarly journals Misconceptions and lack of vaccine confidence: even First Responders are not spared

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Riccò ◽  
L Vezzosi ◽  
F Balzarini ◽  
A G Mezzoiuso ◽  
L Veronesi ◽  
...  
Keyword(s):  
Risk Perception ◽  
Health And Safety ◽  
First Responders ◽  
Cross Sectional Study ◽  
Vaccination Status ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Vaccination Rates ◽  
Attitudes And Practices

Abstract Introduction First Responders (FR) are front-line healthcare workers potentially exposed to different infectious agents. Characterizing their knowledge, attitudes and practices (KAP) towards immunizations has therefore the potential to significantly improve occupational health and safety. Methods A questionnaire-based cross-sectional study was performed during October 2018, collecting a convenience sample among FR from the Parma Province. Participants were inquired on 3 recommended vaccinations (i.e. seasonal influenza vaccine, SIV; measles vaccine, MeV; pertussis vaccine, Pa) and for meningococcal vaccines (MEN, not officially recommended in FR). Knowledge status (KS) and Risk Perception (RP) were assessed as percent values. Multivariate odds ratios (mOR) for factors associated with vaccination status were calculated by means of a binary logistic regression analysis. Results A total of 161 questionnaires were retrieved (mean age 45.1±14.1 years; seniority 10.8 ± 8.6 years). Internal consistency was good (Cronbach’s alpha = 0.894). KS was unsatisfying (46.5% ± 32.4) with uncertainties on the recommendations for MeV and MEN (39.1% and 34.2% incorrect answers). The majority of respondents were favorable towards MEN (89.4%), MeV (87.5%), Pa (83.0%), while 55.3% exhibited a favorable attitude for SIV, and 28.0% had received SIV 2018 (self-reported lifetime status for MEN 26.1%, MeV 42.2%, Pa 34.8%). RP was unsatisfying, particularly for SIV (33.9% ± 18.4). Interestingly enough, neither KS nor RP were associated with vaccination rates, being the main predictor for SIV 2018 a seniority ≥ 10 years (mOR 3.26, 95%CI 1.35-7.91), and higher educational achievements for both Pa (mOR 3.27, 95%CI 1.29-8.30) and MeV (mOR 2.69, 95%CI 1.09-6.65). Conclusions Reasons for vaccination gaps in FR apparently do not find their roots only in FRs’ incomplete KS or RP. However, the very low vaccination rates for SIV, MeV and Pa recommends stronger and more appropriate information campaigns. Key messages Main drivers of vaccination status in First Responders are not solely their knowledge status or risk perception. Achieving better vaccination rates in First Responders requires the understanding of a complex interplay of individual factors.

SAT0600 PNEUMOCOCCAL VACCINATION IN PATIENTS WITH AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASES, TREATED WITH BIOLOGICAL THERAPY AND WITH A LOW LEVEL OF ANTIBODIES - A COHORT STUDY OF PATIENTS WITH VARYING VACCINATION STATUS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1258.1-1259
Author(s):  
L. Strandbygaard ◽  
S. Larsen Rasmussen ◽  
K. Fuursted ◽  
K. Hay Kragholm ◽  
P. C. Leutscher ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Antibody Level ◽  
Pneumococcal Vaccination ◽  
Vaccination Status ◽  
Inflammatory Rheumatic Diseases ◽  
Protective Level ◽  
Eular Recommendations ◽  
Dmard Treatment

Background:Risk of infection is increased in patients with autoimmune inflammatory rheumatic diseases (AIRD)1. Furthermore, disease-modifying antirheumatic drug (DMARD) treatment contributes to this risk2. To reduce the risk of serious infections, it is recommended that patients are vaccinated againstStreptococcus pneumoniae3. However, some AIRD patients do not develop or maintain an adequate antibody response after pneumococcal vaccination4.Objectives:The aim of the study was to examine the proportion of patients with low antibody levels, who achieved a protective level of pneumococcal antibodies after vaccination.Methods:Pneumococcal antibodies were measured by a serological assay in patients treated with biologics in a rheumatology outpatient clinic. Vaccination with 23-valent-pneumococcal polysaccarid vaccine was then offered to patients with a protective antibody level below the defined threshold and pneumococcal antibody level was measured at follow-up 2-3 months later. The patients continued their DMARD treatment without any changes.Demographic and clinical data were collected, including age, sex, AIRD diagnosis, duration and activity (high/low), in addition to treatment (biologics, prednisolone, methotrexate) and previous vaccination history.Results:A total of 248 patients with inadequate antibody level accepted vaccination and among those, 137 patients (55%) had previously been vaccinated, 98 patients had not previously been vaccinated and for 13 patients data on vaccination status could not be obtained.At follow-up, 84 patients (34%) achieved a protective level of antibodies. Use of methotrexate as part of the DMARD regimen was associated with an unprotected level of pneumococcal antibodies (Figure 1) (p<0,001). There was no similar association with respect to use of biologics.Figure 1In the group of patients who had previously been vaccinated, time between vaccinations spanned from 20 to 111 months, median 49 months.There was an association between previous vaccination, and failure in achieving a protective antibody level (Figure 1) (p=0,02), as well as an association between less than 5 years (60 months) between vaccinations and not achieving a protective level.Conclusion:We found that only one-third of patients achieved a protective pneumococcal antibody level after vaccination. Methotrexate treatment was associated with a decreased antibody response, which was not the case for treatment with biologics or prednisolone.Among patients who had previously been vaccinated, significantly less achieved a protective level of antibodies, compared to patients who had not been vaccinated. All 248 patients had a low antibody level at baseline, despite 137 being previously vaccinated.Further studies are warranted to show whether or not a short discontinuation of methotrexate, will better the response to vaccination.References:[1]Wolfe, F. et al. The mortality of rheumatoid arthritis.Arthritis Rheum1994;37(4):481–494.[2]Ramiro, S. et al.). Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis.Ann Rheum Dis2017;76(6):1101–1136.[3]van Assen S. et al. (). EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases.Ann Rheum Dis2011;70(3):414–422.[4]Hua, C. et al. Effect of methotrexate, anti-tumor necrosis factor alpha, and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: a systematic review and meta-analysis.Arthritis Care Res 2014;66(7):1016–1026.Disclosure of Interests:None declared

scholarly journals Factors associated with Missed Opportunities for Vaccination among children in the first year of life at a tertiary health facility in Lagos

2020 ◽  
Vol 6 (3) ◽  
pp. 287-297
Author(s):  
OA Kehinde ◽  
YA Kuyinu ◽  
OO Odusanya
Keyword(s):  
Health Facility ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Vaccination Status ◽  
First Year ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Vaccination Rates ◽  
Factors Associated ◽  
First Year Of Life

Background: Low vaccination rates in children remain a major problem in resource-poor areas of the world. Missed opportunities for vaccination may be one of the important contributors to the menace. Objectives: To determine the prevalence of missed opportunities for vaccination and identify factors associated with this among Nigerian children in the first year of life. Methods: The study was a descriptive, cross-sectional study of children who were recruited consecutively and data were obtained using a questionnaire. Results: Two hundred and fifty-six children were recruited. The prevalence of missed opportunities for vaccination was 11.3%. Gender (p = 0.04) and parental socioeconomic status (p = 0.008) were significantly associated with missed opportunities for vaccination. Non- availability of required vaccines and reluctance to open a multi-dose vial of vaccine caused MOV in 55.5% and 51.8% of children respectively. The evaluation of vaccination status among subjects who were not fully vaccinated by health workers was low at 18.3%. Conclusion: The rate of missed opportunities for vaccination was low. Educating caregivers and encouraging health workers to evaluate the vaccination status of children at every contact with a health facility may reduce the prevalence of missed opportunities for vaccination.

scholarly journals Vaccination Rates and Adherence to Guidelines in Splenectomy Patients: An Observational Cross-sectional Study

2020 ◽  
Vol 25 (4) ◽  
pp. 589-594
Author(s):  
Nursel Çalık Başaran ◽  
Lale Özışık ◽  
Oğuz Abdullah Uyaroğlu ◽  
Mine Durusu Tanrıöver ◽  
Derya Karakoç ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Vaccination Status ◽  
Solid Organ ◽  
Sectional Study ◽  
Patient Centered ◽  
Cross Sectional ◽  
Adherence To Guidelines ◽  
Vaccination Rates ◽  
Encapsulated Bacteria ◽  
Solid Organ Malignancy

Introduction: Splenectomy, whatever the reason, is an absolute indication for vaccination against encapsulated bacteria in order to prevent overwhelming post-splenectomy infections. This study aimed to determine compliance to immunization guidelines for splenectomy in General Surgery Clinics. Materials and Methods: In this observational cross-sectional study, we included patients who underwent splenectomy between April 2016 and April 2018, and recorded the patient data and vaccination status. Results: Splenectomy was performed in 65 patients, 40 (61.5%) were male and median age was 56 (19-90) years. Six of the operations were emergent, 21 were planned and 38 were urgent mostly due to solid organ malignancy. Only 14 (21.5%) patients were vaccinated with Haemophilus influenzae, meningococcal and pneumococcal vaccines according to the guidelines (≥2 weeks before the operation). 14 of the 21 patients (66.6%) who underwent planned splenectomy were vaccinated appropriately. Conclusion: Compliance with vaccination guidelines was low before splenectomy operations. There is a room for improvement particularly for patients undergoing elective splenectomy. A patient-centered team strategy is required to vaccinate patients at the stage of splenectomy planning.

scholarly journals FRI0607-HPR FREQUENCY AND PATIENTS BELIEFS ON VACCINATION IN RHEUMATIC DISEASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 909.1-909
Author(s):  
M. Viola ◽  
A. Benitez ◽  
C. Garbarino ◽  
G. Rodriguez ◽  
F. Benavidez ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hepatitis B ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Inflammatory Rheumatic Diseases ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Eular Recommendations

Background:Infectious diseases are increased in patients with rheumatic disorders; vaccination improves morbidity and mortalityObjectives:The aim of this study was to describe the frequency of vaccination in patients with rheumatic disorders and to compare the results with those obtained in 2009 and 2013 in a similar population. We also identified factors leading to lack of vaccination and patients beliefs on vaccines.Methods:Multicentric cross sectional study in patients with autoinmune diseases from external rheumatology offices. Evaluation of vaccination status and patients´ knowledge about vaccines were studied. A comparative analysis was carried out with the series registered in 2009 and 2013 in a similar population.Results:179 patients (158 female, 88.3% and 21 male, 11.7%) were evaluated. Median age was 52 years. Main pathologies were: Rheumatoid Arthritis 65.9% (n:118), Systemic Lupus Erythematosus 11.7% (n:21), Systemic Sclerosis 3.9% (7), Sjogren Syndrome n = 3.4% (n:6), other diseases 15% (n: 27). Median disease duration: 8.87 years. Ninety three percent of patients (n:167) were taking inmunomodulators and 36.8% (n: 66) were using oral corticosteroids (20mg/day or less); 26,8% patients (n: 48) were receiving biological therapies. Vaccination frequency in the population was: Influenza 82% (147); 13-valent conjugate pneumococcal 69.3% (124), 23-valent pneumococcal 64.2% (115) and hepatitis B 62% (111). Comparative with 2009 and 2013 series there was an increase in the rate of vaccinated patients: influenza (82% vs. 39,1% and 74,2% respectively), antineumococcal (64% vs. 17% and 29%) and hepatitis B (62% vs. 6,7% and 26,7%).Reasons for non-vaccination were absence of medical indication (41% of patients for hepatitis B; 32% for 23-valent pneumococcal; 38% for 13-valent pneumococcal and 34% for influenza).139 patients (77, 7%) knew the benefits of vaccines, 164 (91, 6%) thought vaccines are useful; 134 (74,9%) reported that vaccines may decrease dying probability, 155 (86,5%) thought that vaccines are effective to prevent diseases and 149 patients (83,2%) believed that they prevent serious infections. 71 patients (39%) believed that vaccines can lead to serious consequences and 99 (55,3%) that they are more likely to acquire infections than the rest of the population.Conclusion:Frequency of vaccination has increased since 2009 but there is still misinformation regarding vaccines risks and benefits. Promotion and information is essential to improve adherence.References:[1]2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Furer V, et al. Ann Rheum Dis 2020;79:39–52[2] Vaccines and Disease-Modifying Antirheumatic Drugs: Practical Implications for the Rheumatologist. Friedman MA et al. Rheum Dis Clin North Am. 2017 Feb; 43 (1):1-13.[3] Recommendations and barriers to vaccination in systemic lupus erythematosus. Garg M et al. Autoimmun Rev. 2018 Oct; 17 (10):990-1001.[4] Comparison of national clinical practice guidelines and recommendations on vaccination of adult patients with autoimmune rheumatic diseases. Papadopoulou D. et al. Rheumatol Int. 2014 Feb;34 (2):151-63.[5] Guías de recomendaciones de prevención de infecciones en pacientes que reciben modificadores de la respuesta biológica. Jordán R. Et al. Rev Arg Reumatol. 2014; 25 (2): 08-26.Disclosure of Interests:Malena Viola: None declared, Alejandro Benitez: None declared, Cecilia Garbarino: None declared, Gonzalo Rodriguez: None declared, Federico Benavidez: None declared, Claudia Peon: None declared, Eliana Soledad Blanco: None declared, Hernan Molina: None declared, Gimena Gómez: None declared, griselda redondo: None declared, Maria DeLaVega: None declared, Dario Mata: None declared, Augusto Riopedre: None declared, Osvaldo Messina Speakers bureau: Amgen; Americas Health Foundation; Pfizer

scholarly journals POS1145 PREVALENCE OF CHONDROCALCINOSIS IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES – FREQUENTLY FOUND IN PATIENTS WITH RHEUMATOID ARTHRITIS AND VICE VERSA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 851.3-852
Author(s):  
M. Krekeler ◽  
X. Baraliakos ◽  
S. Tsiami ◽  
J. Braun
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Radiographic Finding ◽  
Cross Sectional Study ◽  
Calcium Pyrophosphate ◽  
Inflammatory Rheumatic Diseases ◽  
Cross Sectional ◽  
Crystal Deposition ◽  
Short Disease Duration ◽  
Hands And Feet

Background:Calcium pyrophosphate deposition disease (CPPD), also known as pseudogout, is a prominent member of the crystal deposition diseases much like gout where urate crystals are the pathogens. CPPD is differentiated from chondrocalcinosis, a radiographic finding showing joint calcification, which may or may not be relevant for the clinical picture of patients (1).Objectives:To determine the prevalence of chondrocalcinosis in different inflammatory rheumatic diseases.Methods:In a retrospective cross-sectional study design we reviewed the records of not established new patients presenting to our center between 1.1.2016 and 31.12.2018. Based on the availability of radiographs of hands and feet, 514 patients were identified including 181 patients with CPPD, 273 with rheumatoid arthritis (RA), 143 seropositive (52.4%) and 130 seronegative, 30 with gout and 30 with polymyalgia rheumatica (PMR). Radiographs of hands and feet were available from all patients, of the knee in 376 cases. All images were read by two experienced readers with no access to clinical data.Results:Almost all patients had a short disease duration of < 1 year. In patients diagnosed with CPPD all radiographs showed chondrocalcinosis (93%) at some location, mostly in the hands. This was different in seronegative (36.5%) and seropositive (30.3%) RA. Chondrocalcinosis was found less frequently also in gout (18.8%) and PMR (12.5%). More data are shown in the Table 1. Radiographic chondrocalcinosis was present in more than one joint in 36.6% patients with CPPD, in 11.9% in seropositive and in 17.3% in seronegative RA. Patients with CPPD were older and had acute attacks more often than RA patients. While RA patients were more frequently on methotrexate (MTX), patients with CPPD were more often on colchicine.Table 1.Radiographic and clinical features of the examined patientsConclusion:There were a lot of similarities but also some important differences between patients with CPPD and RA with no major differences between seropositive and seronegative RA. Of interest, radiographic chondrocalcinosis was seen in more than a third of RA patients. Importantly, clinical symmetry of arthritis and involvement of hands did not differentiate between CPPD and RA, mainly the acuteness of attacks did. Co-occurrence of both diseases was frequently observed. There was no major difference between seropositive and seronegative RA.References:[1]Rosenthal AM, Ryan LM. N Engl J Med. 2016Disclosure of Interests:None declared.

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