Infectious comorbidities in patients with rheumatoid arthritis: Status praesens

Белов, Б. С.; Тарасова, Г. М.; Буханова, Д. В.

doi:10.14412/1996-7012-2019-3-102-108

Sovremennaâ revmatologiâ

2019

DOI: 10.14412/1996-7012-2019-3-102-108

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Infectious comorbidities in patients with rheumatoid arthritis: Status praesens

Б. С. Белов¹,

Г. М. Тарасова²,

Д. В. Буханова³

Abstract: Ушедший в историю XX в. ознаменовался беспрецедентно активной борьбой с инфекционными заболеваниями, блестящими открытиями и достижениями в этой области. Однако в современных условиях инфекционные болезни по-прежнему сохраняют свое значение. Это объясняется динамичным характером естественных и антропогенно детерминированных природных процессов, изменением нозологической структуры инфекционных болезней, ростом международных связей и т. п. По прогнозам Всемирной организации здравоохранения, инфекционные заболева… Show more

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Cited by 4 publications

References 49 publications

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Comorbid infections in spondyloarthritis: a modern view of the problem

Муравьева¹,

Белов²,

Baranova³

et al. 2020

Sovremennaâ revmatologiâ

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The review considers the problem of comorbid infections (CIs) in ankylosing spondylitis and psoriatic arthritis (PsA) as the main nosological entities of spondyloarthritis (SpA). It analyzes the frequency of CIs during therapy with biological agents and targeted synthetic disease-modifying anti-rheumatic drugs. It is concluded that the problem of CI in SpA deserves the closest attention. The review also shows the importance of preventive measures for CI in the treatment of SpA. It is in particular noted that in accordance with the updated guidelines of the European League Against Rheumatism and other rheumatology research associations, all patients with immunemediated inflammatory rheumatic diseases (including SpA) on immunosuppressive therapy are recommended to get influenza and pneumococcal vaccines due to the high risk of death from respiratory tract infections. Moreover, vaccination is indicated even for patients with an expected suboptimal response. The review gives the main points of the recommendations of the Medical Board of the National Psoriasis (Ps) Foundation on the use of recombinant Herpes zoster vaccine in patients with Ps/PsA. There is a need for further investigations of the frequency and pattern of CIs and the impact of new therapy options on the prevalence of CIs in patients with SpA. Determination of the effectiveness and safety of vaccination in this patient population should become an important area for future investigations.

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Comorbid infections in spondyloarthritis: a modern view of the problem

Муравьева¹,

Белов²,

Baranova³

et al. 2020

Sovremennaâ revmatologiâ

Self Cite

View full text Add to dashboard Cite

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Immunogenicity, safety and efficacy of 23-valent pneumococcal polysaccharide vaccine in patients with inflammatory joint diseases (preliminary data)

et al. 2021

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Intoduction. Currently, for the treatment of patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), basic anti-inflammatory drugs and biological drugs are widely used to effectively control the activity of the disease. However, the use of these drugs is associated with an increased risk of developing comorbid infections, some of which can be prevented by vaccination. Objective. To evaluate the immunogenicity, safety, and clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) in patients with RA and SpA.Materials and methods. The study included 122 patients: 79 - with RA, 43-with SpA. Most patients had a history of two or more cases of lower respiratory tract infections, 2 patients reported a monthly exacerbation of chronic sinusitis, one patient reported the development of otitis media every 2-3 months. At the time of inclusion in the study, most patients received immunosuppressive therapy. PPV-23 was administered in an amount of 1 dose (0.5 ml) subcutaneously against the background of anti-rheumatic therapy. The level of antibodies to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clin-ical Diagnostics s.r.o., Czech Republic) before vaccination, 1, 3 and 12 months after vaccination. In addition, the tolerance of PPV-23, the frequency of pneumonia, and the effect on the activity of RA and SpA were evaluated (according to the dynamics of DAS28 and BASDAI).Results. At 1, 3, and 12 months after vaccination, the concentration of antibodies to pneumococcal capsular polysaccharide was significantly higher than the baseline values, which indicates sufficient immunogenicity of PPV-23. There was no negative effect of vaccination on the activity of the underlying disease and the occurrence of new autoimmune disorders. In the majority of patients (67% - RA, 81.4% - SpA), the tolerance of the vaccine was good. During the follow-up period, none of the patients developed pneumonia. Patients suffering from frequent sinusitis and otitis media reported the absence of these infections after vaccination.Conclusion. Preliminary results of the study indicate sufficient immunogenicity, safety, and clinical efficacy of PPV-23 in patients with RA and SpA.

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The frequency and structure of comorbid infections in patients with spondyloarthritis (preliminary own data)

2021

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Introduction. Data on the frequency of comorbid infections (CI) in patients with spondyloarthritis (SpA) are few and contradictory. Objective. The aim of the study was to study the frequency and structure of CI in the inpatient population of SpA patients in the course of a one-moment retrospective study.Subjects and methods. The study included 205 patients with SPA: 119 men, 86 women, the age of patients was 39.02 ± 12.2 years, the duration of the disease was 129.3 ± 104.3 months. Ankylosing spondylitis was diagnosed in 133 patients, psoriatic arthritis in 55, spondyloarthritis associated with Crohn’s disease – in 1, undifferentiated spondyloarthritis – in 16. Most patients, along with nonsteroidal anti-inflammatory drugs, received glucocorticoids, basic anti-inflammatory drugs, and biological drugs. Patients were interviewed by a research doctor with the completion of a unified questionnaire, additional data were obtained from medical documentation.Results. 20% of patients reported more frequent CI development after the SpA debut. 28.7% of patients reported a more severe course of previously observed CI. Temporary discontinuation of therapy due to the development of CI occurred in 25.4% of patients. Exacerbation of SpA after CI was diagnosed in 40% of patients. In general, the leading place in the structure of CI was occupied by infections of the respiratory tract and ENT-organs, the second place belonged to herpes-viral infections. Serious CI accounted for 6.8% of all cases of CI. In SpA patients receiving immunosuppressive therapy, there was an increase in the frequency of acute nasopharyngitis, sinusitis, acute bronchitis, pneumonia and herpes-viral infections. However, cases of CI have also been reported in patients who have never received immuno-suppressive drugs.Conclusion. The data obtained indicate the important of the problem of CI in SpA. Further studies are needed on large samples of patients in order to find significant risk factors for CI, study their relationship with clinical characteristics and influence on the course of SpA.

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Infectious comorbidities in patients with rheumatoid arthritis: Status praesens

Cited by 4 publications

References 49 publications

Comorbid infections in spondyloarthritis: a modern view of the problem

Comorbid infections in spondyloarthritis: a modern view of the problem

Immunogenicity, safety and efficacy of 23-valent pneumococcal polysaccharide vaccine in patients with inflammatory joint diseases (preliminary data)

The frequency and structure of comorbid infections in patients with spondyloarthritis (preliminary own data)

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