The Practice Guideline for Vaccinating Korean Patients with Autoimmune Inflammatory Rheumatic Disease

Seo, Yu Bin; Moon, Su Jin; Jeon, Chan Hong; Song, Joon Young; Sung, Yoon Kyoung; Jeong, Su Jin; Kwon, Ki Tae; Kim, Eu Suk; Kim, Jae-Hoon; Kim, Hyoun‐Ah; Park, Dong Jin; Park, Sunghoon; Park, Jin Kyun; Ahn, Joong Kyong; Oh, Ji Seon; Yun, Jae Won; Lee, Juhyun; Lee, Hee Young; Choi, Min Joo; Choi, Won Suk; Choi, Young Hwa; Choi, Jung Hyun; Heo, Jung Yeon; Cheong, Hee Jin; Lee, Shin Seok

doi:10.3947/ic.2020.52.2.252

Cited by 15 publications

(19 citation statements)

References 122 publications

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“…Clinical practice guidelines for vaccination of patients with AIIRD developed jointly by the Korean College of Rheumatology and the Korean Society of Infectious Diseases and the 2019 update of the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with AIIRD should be followed for COVID-19 vaccination. 41 59 60 The decision on COVID-19 vaccination should be shared between physicians (rheumatologists and primary care physicians) and patients. Ideally, the vaccination should be administered when the patient's AIIRD is in a quiescent state and before the commencement of immunosuppressive therapy, if clinically feasible.…”

Section: Recommendationsmentioning

confidence: 99%

COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: Clinical Guidance of the Korean College of Rheumatology

et al. 2021

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The coronavirus disease 2019 (COVID-19) pandemic has caused more than 100 million infections and 2 million deaths worldwide. In up to 20% of cases, COVID-19 infection can take a severe, life-threatening course. Therefore, preventive measures such as mask-wearing, hand hygiene, and social distancing are important. COVID-19 vaccines that use novel vaccine technology can prevent up to 95% of infections. However, the uncertainty regarding the efficacy and safety of vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), who are immunocompromised due to underlying immune dysfunction and concomitant immunosuppressive treatment, warrants clear guidance. A task force of the Korean College of Rheumatology formulated a set of vaccination guidance based on the currently available data and expert consensus. The currently available COVID-19 vaccines are considered to be safe and effective. Every patient with AIIRD should receive one of the available COVID-19 vaccines unless contraindicated for medical reasons such as prior allergy/anaphylaxis to the COVID-19 vaccine or its components. Patients should continue immunosuppressive treatment for their underlying AIIRD, including biological and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Corticosteroids should be reduced to the lowest dose possible without aggravating the AIIRD. To improve the vaccine response, methotrexate can be withheld for 1–2 weeks after each vaccination, and the timing of rituximab and abatacept infusion should be adjusted if clinically acceptable. Rheumatologists should play a leading role in educating and vaccinating patients with AIIRD.

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Section: Recommendationsmentioning

confidence: 99%

COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: Clinical Guidance of the Korean College of Rheumatology

et al. 2021

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“…Vaccination studies in PRD on immunomodulatory drugs (other than B cell depleting therapy) have shown sufficient protective efficacy with common non-live vaccines including influenza and pneumococcal vaccines, despite somewhat reduced immunogenicity particularly with methotrexate and abatacept (21, 24, 27).…”

Section: Resultsmentioning

confidence: 99%

“…Vaccination of household contacts has been advocated by societies such as European Alliance of Associations for Rheumatology (EULAR) (20) and Infectious Diseases Society of America (IDSA) (28) for a variety of inactivated and live vaccines (except for the oral polio vaccination (20, 21, 28)). Increasingly, epidemiologic studies have demonstrated SARS-CoV-2 transmission in close contacts due to asymptomatic and pre-symptomatic infections (40-42), highlighting the importance of extending vaccinations to household contacts in order to protect vulnerable patients.…”

Section: Resultsmentioning

confidence: 99%

Recommendations for COVID-19 Vaccination in People with Rheumatic Disease:Developed by the Singapore Chapter of Rheumatologists

Santosa

Arkachaisri

et al. 2021

Preprint

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Aim People with rheumatic diseases (PRD) remain vulnerable in the era of the COVID-19 pandemic. We formulated recommendations to meet the urgent need for a consensus for vaccination against SARS-CoV-2 in PRD. Methods Systematic literature reviews were performed to evaluate (1) outcomes in PRD with COVID-19; (2) efficacy, immunogenicity and safety of COVID-19 vaccination; and (3) published guidelines/recommendations for non-live, non-COVID-19 vaccinations in PRD. Recommendations were formulated based on the evidence and expert opinion according to the Grading of Recommendations Assessment, Development and Evaluation methodology. Results The consensus comprises two overarching principles and seven recommendations. Vaccination against SARS-CoV-2 in PRD should be aligned with prevailing national policy and should be individualized through shared decision between the healthcare provider and patient. We strongly recommended that eligible PRD and household contacts be vaccinated against SARS-CoV-2. We conditionally recommended that the COVID-19 vaccine be administered during quiescent disease if possible. Immunomodulatory drugs, other than rituximab, can be continued alongside vaccination. We conditionally recommended that the COVID-19 vaccine be administered prior to commencing rituximab if possible. For patients on rituximab, the vaccine should be administered a minimum of 6 months after the last dose and/or 4 weeks prior to the next dose of rituximab. Post-vaccination antibody titres against SARS-CoV-2 need not be measured. Any of the approved COVID-19 vaccines may be used, with no particular preference. Conclusion These recommendations provide guidance for COVID-19 vaccination in PRD. Most recommendations in this consensus are conditional, reflecting a lack of evidence or low-level evidence.

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“…Without intervention, patients with chronic hepatitis B (CHB) are at high risk of developing serious complications, such as liver cirrhosis (LC), liver failure, and hepatocellular carcinoma (HCC), causing about 650,000 deaths a year from HBV-related liver failure (3)(4)(5). Recent guidelines recommend antiviral treatment with nucleos(t)ide analogs (NAs) and interferon (IFN) for CHB patients (6)(7)(8). The biggest obstacle for NAs or IFN to eliminate HBV mainly attributes to the formation and persistence of covalently closed circular DNA (ccc DNA), a replication template with full virus functionality, inside nucleus of hepatocytes.…”

Section: Introductionmentioning

confidence: 99%

“…Currently approved NAs agents for CHB include nucleoside analogs (lamivudine, telbivudine, ETV) and nucleotide analogs (adefovir dipivoxil, TDF, tenofovir alafenamide) worldwide. These drugs have been proven to be effective in stalling the progression of disease and improving prognosis in clinical practice for many years, differing in antiviral and clinical efficacy, drug resistance, tolerance, and safety, with ETV and TDF recommended as the first-line oral antiviral agents in current clinical practice guidelines (6)(7)(8)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Tenofovir Disoproxil Fumarate Is Superior to Entecavir in Reducing Hepatitis B Surface Antigen for Chronic Hepatitis B in China: 2-Year Comprehensive Comparative Result of a Matched Comparative Study

Yang

Cai

et al. 2021

Front. Med.

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Aim: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are equally recommended as the first-line antiviral treatments for chronic hepatitis B (CHB) at present. We aimed to compare the long-term efficacy and safety between ETV and TDF therapy in CHB patients who had not received nucleoside analog treatment.Method: In this single-center retrospective study, 414 patients who received ETV (290 patients) or TDF (124 patients) therapy at our center from January 2017 to May 2019 were included. To reduce the imbalance of baseline variables, propensity score matching (PSM) was employed to yield 124 pairs of patients at a ratio of 1:1 based on the treatment regimen.Result: After PSM, the cumulative rate of patients who achieved complete virological response (CVR) was not different by drug therapy at each inspection time (1, 3, 6, 12, 18, and 24 months). Subgroup analysis on HBeAg status and level of HBV DNA demonstrated that evolution of proportion of achieving CVR was not significantly different between groups. Despite the insignificant incidence of HBsAg seroclearance in either group, patients in TDF group achieved higher on-treatment HBsAg decline at each inspection time (1, 3, 6, 9, 12, 18, and 24 months), 0.39, 0.51, 0.61, 0.64, 0.68, 0.76, and 0.91 log IU/mL, respectively; while the corresponding reduction were 0.27, 0.37, 0.40, 0.45, 0.48, 0.55, and 0.66 log IU/mL in ETV group (p < 0.05). In subgroup analysis, we found that the significant difference still existed in patients with high baseline HBsAg level (>3 log IU/mL). Additionally, the proportion of patients who achieved on-treatment HBsAg decline >1 log IU/mL in TDF and ETV group was 33.3 and 17.1% (p < 0.01) at the 12th month, 44.4 and 29.5% (p = 0.03) at the 24th month, respectively. Mean increase in serum creatinine from baseline was 0.10 and 0.08 mg/dL in TDF and ETV group (p = 0.11), with no patient experienced acute kidney injury.Conclusions: TDF has higher potency in reducing HBsAg than ETV in this study. Considering the effect still existed in patients with high HBsAg level (>3 log IU/mL), TDF might be a superior therapeutic regimen combining with its relatively safety.

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The Practice Guideline for Vaccinating Korean Patients with Autoimmune Inflammatory Rheumatic Disease

Cited by 15 publications

References 122 publications

COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: Clinical Guidance of the Korean College of Rheumatology

COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: Clinical Guidance of the Korean College of Rheumatology

Recommendations for COVID-19 Vaccination in People with Rheumatic Disease:Developed by the Singapore Chapter of Rheumatologists

Tenofovir Disoproxil Fumarate Is Superior to Entecavir in Reducing Hepatitis B Surface Antigen for Chronic Hepatitis B in China: 2-Year Comprehensive Comparative Result of a Matched Comparative Study

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