Herpes Zoster Vaccine Response in Inflammatory Bowel Disease Patients on Low-dose Immunosuppression

Wasan, Sharmeel K.; Zullow, Samantha; Berg, Adam; Cheifetz, Adam S.; Ganley-Leal, Lisa; Farraye, Francis A.

doi:10.1097/mib.0000000000000743

Cited by 27 publications

(21 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The UK Department of Health Green Book vaccination guide Chapter 6730 also suggests that all live vaccines can be considered for those on low-dose immunosuppression as defined above, including low-dose immunosuppressive drugs in combination with prednisolone up to 20 mg. There is evidence from a small controlled study that the use of zoster vaccine in IBD patients on low-level immunosuppression does not result in adverse effects, although antibody titres were somewhat lower than those in vaccinated IBD patients not taking immunosuppressive drugs 736. Live vaccination must not be given to those taking biologics, and should only be undertaken for those on low-level immunosuppression after careful consideration of the risks and benefits in conjunction with the patient.…”

Section: Common Disease Considerationsmentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,608

1,816

View full text Add to dashboard Cite

Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

show abstract

Section: Common Disease Considerationsmentioning

confidence: 99%

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Lamb

Kennedy

Raine

et al. 2019

Gut

1,608

1,816

View full text Add to dashboard Cite

show abstract

“…33,34 It has also been shown that the immunological response to vaccination is sometimes decreased in patients exposed to immunosuppressive therapy. [35][36][37] How to treat IBD after a serious infection…”

Section: What Type Of Vaccine For Which Type Of Patients?mentioning

confidence: 99%

Predicting, Preventing, and Managing Treatment-Related Complications in Patients With Inflammatory Bowel Diseases

Beaugerie

Rahier

Kirchgesner

2020

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

show abstract

“…The Centers for Disease Control and Prevention (CDC) suggest that vaccination is safe for those patients receiving low-dose immunosuppression (<20 mg/d of prednisone or equivalent), 61 although other studies have shown a dimimished antibody response to the LZV in patients on low-dose immunosuppressive therapy. 68 HZ vaccination in patients with IBD taking anti-TNF medication has now been shown to be relatively safe. 69 Due to the potential for prolonged viremia, a period of time between vaccination and immunosupression could theoretically decrease the risk of reactivation.…”

Section: Prevention Of Hzmentioning

confidence: 99%

Herpes Zoster in Patients Receiving JAK Inhibitors For Ulcerative Colitis: Mechanism, Epidemiology, Management, and Prevention

Colombel

2018

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

Increased risk of herpes zoster (HZ) has been observed in patients with immune-mediated diseases, including rheumatoid arthritis (RA), psoriasis (PsO), and inflammatory bowel disease; this risk can be further increased by the use of immunosuppressive therapy. One advancing modality of therapy for these diseases is Janus kinase (JAK) inhibition. Tofacitinib is an oral JAK inhibitor for the treatment of RA and psoriatic arthritis, which is currently under investigation for the treatment of ulcerative colitis (UC) and was previously investigated for psoriasis. JAK inhibitors have been associated with HZ events in patients across a number of indications. The pathogenesis underlying this risk of HZ is currently unknown. An increased risk of HZ has been noted in patients receiving immunosuppressive therapies for UC, including tofacitinib. In clinical trials, there was a dose-dependent risk of HZ (higher dose linked with increased risk). However, the majority of HZ cases are nonserious and noncomplicated, mild to moderate in severity, and manageable without permanent discontinuation of treatment. This review will discuss HZ risk in patients receiving JAK inhibitors, focusing on tofacitinib with respect to the potential mechanisms and epidemiology of HZ. Current guidelines for the prevention of HZ will be highlighted, and proposed management reviewed.

show abstract

Herpes Zoster Vaccine Response in Inflammatory Bowel Disease Patients on Low-dose Immunosuppression

Abstract: IBD patients on low-dose immunosuppressive therapy have a blunted immune response to HZV as compared with nonimmunosuppressed subjects. Despite this, immunosuppressed IBD patients are able to mount a statistically significant immune response. There were no serious adverse events to HZV.

Cited by 27 publications

References 14 publications

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

Predicting, Preventing, and Managing Treatment-Related Complications in Patients With Inflammatory Bowel Diseases

Herpes Zoster in Patients Receiving JAK Inhibitors For Ulcerative Colitis: Mechanism, Epidemiology, Management, and Prevention

Contact Info

Product

Resources

About