scholarly journals Vaccination in Rheumatology: New Data (Based on Recommendations of the European League Against Rheumatism)

2020 ◽  
Vol 65 (1-2) ◽  
pp. 61-67
Author(s):  
B. S. Belov ◽  
G. M. Tarasova ◽  
N. V. Muravyova
Keyword(s):  
Rheumatic Diseases ◽  
Adult Patients ◽  
Morbidity And Mortality ◽  
Future Research ◽  
Inflammatory Rheumatic Diseases ◽  
European League Against Rheumatism ◽  
Immune Mediated ◽  
Prevention Of Infections ◽  
European League

Comorbid infections have a significant effect on morbidity and mortality in modern rheumatology, especially in immune-mediated inflammatory rheumatic diseases (IMIRD). In this regard, vaccination is becoming increasingly important in the prevention of infections in IMIRD. The article analyzes an updated version of the recommendations for vaccination of adult patients with IMIRD, proposed by experts of the European League Against Rheumatism at the end of 2019. The safety and immunogenicity of vaccination associated with the prevention of various infections in patients with IMIRD are discussed. The main directions of future research on this issue are outlined.

scholarly journals Vaccination in rheumatology: present and prospects

2020 ◽  
Vol 2 (37) ◽  
pp. 44-49
Author(s):  
B. S. Belov ◽  
G. M. Tarasova ◽  
D. V. Bukhanova ◽  
N. V. Muravyeva
Keyword(s):  
Clinical Practice ◽  
Hepatitis B ◽  
Genetic Engineering ◽  
Rheumatic Diseases ◽  
Human Papillomaviruses ◽  
Adult Patients ◽  
Influenza Vaccines ◽  
Future Research ◽  
Inflammatory Rheumatic Diseases ◽  
Biological Drugs

In rheumatology in recent years, the importance of comorbid infections has increased significantly, especially in connection with the introduction of genetic engineering biological drugs into clinical practice. One way to solve this problem is to study and actively use various vaccines. This review provides an updated version of the recommendations for vaccinating adult patients with autoimmune inflammatory rheumatic diseases, proposed in 2019 by experts from the European Anti-Rheumatic League (EULAR). Issues regarding the use of influenza vaccines, infections caused by Pneumococci, Hepatitis B viruses, herpes and human papillomaviruses in rheumatological patients are considered. The main directions of future research on this issue are outlined.

Vaccination in immunocompromised adults

2013 ◽  
pp. 717-720
Author(s):  
Sander van Assen ◽  
Marc Bijl
Keyword(s):  
Pneumococcal Infection ◽  
Pneumococcal Vaccination ◽  
Underlying Disease ◽  
Inflammatory Rheumatic Diseases ◽  
Live Vaccines ◽  
Eular Recommendations ◽  
European League Against Rheumatism ◽  
Immunosuppressed Patients ◽  
Humoral Responses ◽  
European League

This chapter addresses all important questions regarding vaccination of patients with autoimmune inflammatory rheumatic diseases (AIIRD). First, the incidence of vaccine-preventable infections in these patients is discussed. Pulmonary infections, including influenza and pneumococcal infection, occur more often in AIIRD patients; herpes zoster and human papillomavirus are also more frequent. The efficacy of vaccination for all European registered vaccines is discussed. Treatment with disease-modifying anti-rheumatic drugs (DMARDs) and biologicals (in particular TNFα‎‎-blocking agents) do not hamper, or only slightly hamper, the immune responses to most vaccines. Rituximab is an exception, severely reducing humoral responses following influenza and pneumococcal vaccination, at least during the first 6 months after administration. Safety of vaccination is an important issue in patients with autoimmune diseases, since increased disease activity of the underlying disease as a result of vaccination is theoretically possible. The available evidence is summarized, suggesting that vaccination is safe in AIIRD patients. Live vaccines, however, are contraindicated in immunosuppressed patients with AIIRD. Finally, the European League Against Rheumatism (EULAR) recommendations are highlighted, summarizing the ’do’s’ and ’don’ts’ of vaccination in adults with AIIRD.

scholarly journals Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001041 ◽  
Author(s):  
Victoria Furer ◽  
Christien Rondaan ◽  
Marloes Heijstek ◽  
Sander van Assen ◽  
Marc Bijl ◽  
...  
Keyword(s):  
General Population ◽  
Hepatitis B ◽  
Incidence Rate ◽  
Rheumatic Diseases ◽  
Pneumococcal Disease ◽  
Hpv Infection ◽  
Adult Patients ◽  
Current Evidence ◽  
Inflammatory Rheumatic Diseases ◽  
Pooled Prevalence

ObjectivesThe aims of this study were to update the evidence on the incidence and prevalence rates of vaccine preventable infections (VPI) in patients with autoimmune inflammatory rheumatic diseases (AIIRD) and compare the data to the general population when available.MethodsA literature search was performed using Medline, Embase and Cochrane library (October 2009 to August 2018). The primary outcome was the incidence or prevalence of VPI in the adult AIIRD population. Meta-analysis was performed when appropriate.ResultsSixty-three publications out of 3876 identified records met the inclusion criteria: influenza (n=4), pneumococcal disease (n=7), hepatitis B (n=10), herpes zoster (HZ) (n=29), human papillomavirus (HPV) infection (n=13). An increased incidence of influenza and pneumococcal disease was reported in patients with AIIRD. HZ infection-pooled incidence rate ratio (IRR) was 2.9 (95% CI 2.4 to 3.3) in patients with AIIRD versus general population. Among AIIRD, inflammatory myositis conferred the highest incidence rate (IR) of HZ (pooled IRR 5.1, 95% CI 4.3 to 5.9), followed by systemic lupus erythematosus (SLE) (pooled IRR 4.0, 95% CI 2.3 to 5.7) and rheumatoid arthritis (pooled IRR 2.3, 95% CI 2.1 to 2.6). HPV infection-pooled prevalence ratio was 1.6, 95% CI 0.7 to 3.4 versus general population, based on studies mainly conducted in the SLE population in Latin America and Asia. Pooled prevalence of hepatitis B surface antigen and hepatitis B core antibody in patients with AIIRD was similar to the general population, 3%, 95% CI 1% to 5% and 15%, 95% CI 7% to 26%, respectively.ConclusionCurrent evidence shows an increased risk of VPI in patients with AIIRD, emphasising that prevention of infections is essential in these patients.

BARICITINIB: NEW PHARMACOTHERAPY OPTIONS FOR RHEUMATOID ARTHRITIS AND OTHER IMMUNE-MEDIATED INFLAMMATORY RHEUMATIC DISEASES

2020 ◽  
Vol 58 (3) ◽  
pp. 304-316
Author(s):  
E. L. Nasonov ◽  
A. M. Lila
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatic Diseases ◽  
Janus Kinase ◽  
Inflammatory Rheumatic Diseases ◽  
Jak Inhibitors ◽  
Oral Medications ◽  
Immune Mediated ◽  
Wide Range ◽  
Promising Area ◽  
Medical Advances

Deciphering the mechanisms of the pathogenesis of immune-mediated inflammatory rheumatic diseases (IMIRDs) in conjunction with designing a wide range of biological agents is one of the major medical advances in the 21st century. A new promising area of pharmacotherapy for IMIRDs is associated with the design of the so-called targeted oral medications that primarily include Janus kinase (JAK) inhibitors. The review presents new data on the efficacy and safety of the new JAK inhibitor baricitinib in treating rheumatoid arthritis and other IMIRDs.

Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative

2016 ◽  
Vol 75 (6) ◽  
pp. 965-973 ◽  
Author(s):  
Athan Baillet ◽  
Laure Gossec ◽  
Loreto Carmona ◽  
Maarten de Wit ◽  
Yvonne van Eijk-Hustings ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Literature Review ◽  
Rheumatic Diseases ◽  
Daily Practice ◽  
Gastrointestinal Diseases ◽  
Inflammatory Rheumatic Diseases ◽  
Dissemination And Implementation ◽  
Consensus Process ◽  
European League Against Rheumatism ◽  
Chronic Inflammatory Rheumatic Diseases

In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.

scholarly journals Differential diagnosis in joint and spine damages

2020 ◽  
Vol 14 (2) ◽  
pp. 14-19
Author(s):  
N. V. Chichasova
Keyword(s):  
Differential Diagnosis ◽  
Rheumatic Diseases ◽  
Joint Pain ◽  
Joint Damage ◽  
Diagnostic Strategy ◽  
Common Variants ◽  
European League Against Rheumatism ◽  
Definition Of ◽  
European League ◽  
Key Questions

The lecture covers main approaches to differential diagnosis in rheumatic diseases. It highlights the key questions that should be answered at the primary examination of the patient. The most important signs that can identify severe, sometimes urgent nonrheumatic diseases are presented. The author describes pain of different patterns and intensity and the most common variants of acute or chronic onset of mono-, oligo-, or polyarthritis. The 2016 European League Against Rheumatism (EULAR) definition of arthralgia suspicious for the development of rheumatoid arthritis is given. The lecture presents the signs indicating the inflammatory nature of back pain in cases of suspected spondyloarthritis (SpA), as well as a two-step diagnostic strategy for axial SpA. Attention is paid to the semiotics of joint damage and extra-articular manifestations in various rheumatic diseases. A brief algorithm for a differential diagnostic search for joint pain is given.

scholarly journals Coronavirus disease 2019 (COVID-19) and immune-mediated inflammatory rheumatic diseases: at the crossroads of thromboinflammation and autoimmunity

2020 ◽  
Vol 58 (4) ◽  
pp. 353-367
Author(s):  
E. L. Nasonov ◽  
T. V. Beketova ◽  
T. M. Reshetnyak ◽  
A. M. Lila ◽  
L. P. Ananieva ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Complement System ◽  
Vascular Endothelial Cells ◽  
Basic Mechanism ◽  
Pathological Process ◽  
Human Organism ◽  
Inflammatory Rheumatic Diseases ◽  
Irreversible Damage ◽  
Immune Mediated ◽  
The Complement System

Inflammation and coagulation are key basic mechanism of protection against all potentially pathogenic mechanical and biological factors targeting human organism from inner and outer environment. On the other hand, uncontrolled inflammation results in hypercoagulation, inhibition of anticoagulation and alteration of mechanisms responsible for resolution of inflammation, while production of “procoagulant” mediators (thrombin, tissue factor and others), activation of platelets and of vascular endothelial cells maintains inflammation. All factors taken together serve as the basis for a pathological process called thromboinflammation or immunothrombosis. Currently thromboinflammation is considered in the broad sense as a universal pathogenetic mechanism of numerous widespread acute and chronic conditions, including immune-mediated (autoimmune) inflammatory rheumatic diseases, oftentimes complicated by severe irreversible damage to vital organs. Thromboinflammation gained specific attention during СОVID-19 (coronavirus disease 2019) pandemic, caused by SARS-Cov-2 (severe acute respiratory syndrome Coronavirus-2). COVID-19 is considered currently as systemic thromboinflammation syndrome, manifesting via generalized thrombosis of arterial and venous macro- and microvasculature, termed as COVID-19-coagulopathy. The paper discusses common pathogenetic coagulopathy mechanisms in COVID-19 and immune-mediated (autoimmune) inflammatory rheumatic diseases (IMRDs), associated with overproduction of antiphospholipid antibodies, activation of the complement system, and dis-regulated synthesis of proinflammatory cytokines, etc. Delineating the autoimmune subtype of thromboinflammation, identification of genetic (i.e., genes encoding the complement system and others) and molecular-biologic biomarkers associated with higher occurrence of COVID-19-coagulopathy are the most relevant undertakings for the current practice. Gaining insights into mechanisms of thromboinflammation and converting them into potential pharmacotherapies of IMDs would facilitate and accelerate the drafting of effective therapeutic strategies for COVID-19. 

Reproductive function in women with immune-mediated inflammatory rheumatic diseases

2019 ◽  
Vol 10_2019 ◽  
pp. 51-59
Author(s):  
Vlasova G.A. Vlasova ◽  
Perminova S.G. Perminova ◽  
Kosheleva N.M. Kosheleva ◽  
Nazarenko T.A. Nazarenko ◽  
◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Reproductive Function ◽  
Inflammatory Rheumatic Diseases ◽  
Immune Mediated
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