RT Journal Article
SR Electronic
T1 Are patients with rheumatic diseases on immunosuppressive therapies protected against preventable infections? A cross-sectional cohort study
JF RMD Open
JO RMD Open
FD EULAR
SP e001499
DO 10.1136/rmdopen-2020-001499
VO 7
IS 1
A1 Uta Kiltz
A1 Aylin Celik
A1 Styliani Tsiami
A1 Bjoern Buehring
A1 Xenofon Baraliakos
A1 Ioana Andreica
A1 David Kiefer
A1 Juergen Braun
YR 2021
UL http://rmdopen.bmj.com/content/7/1/e001499.abstract
AB Objective To evaluate the prevalence of infections, prevalence of hospitalisation due to infections, the vaccination status and perceived screening of infections prior to the start of biologic disease modifying antirheumatic drugs (bDMARDs) of a patient cohort with chronic inflammatory rheumatic diseases (CIRD).Methods Consecutive CIRD patients reporting to our specialised centre were prospectively included (n=975) in this cross-sectional study. Data on comorbidities including infections, treatment, vaccination status, screening for latent tuberculosis infection (LTBI) and hepatitis B (HepB) were collected. Antibodies against measles and HepB were measured by ELISA. The vaccination status was assessed by a predefined vaccination score (0–26) categorising patients into four immunisation states: low (0–6), moderate (7–13), good (14–20), high (21–26).Results All patients on bDMARDs (n=499) were screened for LTBI, and 469 for HepB (94%). All LTBI patients (n=16) received isoniazid (3.2%) and 16 chronic HepB patients received lamivudine (3.4%). Protective measles specific IgG-antibodies were found in 901 patients (92.4%). Although 629 patients were educated about vaccination strategies (64.5%), only 540 showed a vaccination card (55.4%). Only 49% of patients had undergone pneumococcal vaccination and less than 30% were protected against HepB and influenza, while 7.6% have not protective antibody titres against measles. No patient met the German national vaccination recommendations requiring a complete documentation of vaccines. The mean vaccination score was 13.3±4.2 with 5.7% of patients having a low, 43.9% a moderate, 47.0% a good and 3.3% a high score.Conclusions The majority of CIRD patients are n0t sufficiently vaccinated against pneumococci, HepB, influenza and measles. Although CIRD patients and general practitioners regularly receive professional information about the need of vaccination, vaccination rates were low to moderate. Interdisciplinary quality projects should be planned to change that inacceptable result.Data are available upon reasonable request. Data sharing statement: Data from this study will be shared upon request. Contact the corresponding author for such inquiries. Data availability statement: The data underlying this article are available in the article and in its online supplementary material.