Vaccinations in adults with chronic inflammatory joint disease: Immunization schedule and recommendations for patients taking synthetic or biological disease-modifying antirheumatic drugs

Dr. Roubille, et al reply

“…Regardless of the other confounding factors, these data reinforce the importance of CV monitoring and appropriate management in these populations. Moreover, in agreement with Castañeda, et al, we also support depression screening and management, as well as vaccinations 7 , given the increased risk of infection associated with the use of biologic agents. Although of great importance, oral health and sexual disorders have not been selected by the Delphi voting process and were not addressed in our review because of the decision to limit our review to 8 questions/situations.…”

Collection and management of selected comorbidities and their risk factors in chronic inflammatory rheumatic diseases in daily practice in France

“…Diphtheria/tetanus/poliomyelitis, influenza and pneumococcus vaccinations are strongly recommended, whereas our suggestions for hepatitis B vaccination and herpes zoster vaccination (Zostavax®) are more informative than prescriptive. [5,[46][47][48][49] Although the risk of herpes zoster is increased in patients treated with TNF inhibitors and Jak inhibitors, we did not give any strong recommendation because i) of a lack of efficacy and safety data in patients with CIRDs, ii) the fact that herpes zoster vaccination is recommended only in the general population after 65 in France and iii) it is a live vaccine and is contraindicated in patients treated with immunosuppressants ( Table 2). [47][48][49][50][51] Given the lack of consensus regarding pertussis and measles vaccinations, no recommendations were formulated.…”

Zona : risques et prévention sous immuno-modulateurs

“…Concernant la sévérité, les études sont plutôt concordantes, avec des formes sévères de zona plus fréquentes sous traitement immuno-modulateurs [5]. Dans une méta-analyse, Che et al ont estimé le pourcentage de formes sévères de 4,9 à 20,9 % sous anti-TNF contre 2 à 5,5 % sous traitement classique [21].…”

“…Ce risque concerne les risques de primo-infection mais également de réactivation virale comme pour l'hépatite B [4] ou les virus de la famille des Herpesviridae dont le VZV. Ainsi, des recommandations de vaccination dans cette population ont été faites, mais sont relativement peu suivies en pratique [5,6].…”