RT Journal Article SR Electronic T1 Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations JF RMD Open JO RMD Open FD EULAR SP e001035 DO 10.1136/rmdopen-2019-001035 VO 5 IS 2 A1 Christien Rondaan A1 Victoria Furer A1 Marloes W Heijstek A1 Nancy Agmon-Levin A1 Marc Bijl A1 Ferdinand C Breedveld A1 Raffaele D’Amelio A1 Maxime Dougados A1 Meliha C Kapetanovic A1 Jacob M van Laar A1 Annette Ladefoged de Thurah A1 Robert Landewé A1 Anna Molto A1 Ulf Müller-Ladner A1 Karen Schreiber A1 Leo Smolar A1 Jim Walker A1 Klaus Warnatz A1 Nico M Wulffraat A1 Sander van Assen A1 Ori Elkayam YR 2019 UL http://rmdopen.bmj.com/content/5/2/e001035.abstract AB Aim To present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating the EULAR evidence-based recommendations.Methods An SLR was performed according to the standard operating procedures for EULAR-endorsed recommendations. Outcome was determined by efficacy, immunogenicity and safety of vaccination in adult patients with AIIRD, including those receiving immunomodulating therapy. Furthermore, a search was performed on the effect of vaccinating household members of patients with AIIRD on the occurrence of vaccine-preventable infections in patients and their household members (including newborns). The literature search was performed using Medline, Embase and the Cochrane Library (October 2009 to August 2018).Results While most investigated vaccines were efficacious and/or immunogenic in patients with AIIRD, some were less efficacious than in healthy control subjects, and/or in patients receiving immunosuppressive agents. Adverse events of vaccination were generally mild and the rates were comparable to those in healthy persons. Vaccination did not seem to lead to an increase in activity of the underlying AIIRD, but insufficient power of most studies precluded arriving at definite conclusions. The number of studies investigating clinical efficacy of vaccination is still limited. No studies on the effect of vaccinating household members of patients with AIIRD were retrieved.Conclusion Evidence on efficacy, immunogenicity and safety of vaccination in patients with AIIRD was systematically reviewed to provide a basis for updated recommendations.