TY - JOUR
T1 - Vaccinations for rheumatoid arthritis
AU - Friedman, Marcia A.
AU - Winthrop, Kevin
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Purpose of review Rheumatoid arthritis (RA) patients experience increased infectious disease-related morbidity and mortality, and vaccinations represent an important element in their care. However, vaccine immunogenicity can be affected by disease-modifying antirheumatic drug (DMARD) therapy, such that vaccine choice and timing can be clinically challenging. We review the indications, safety, and immunogenicity of vaccines in the setting of RA. Recent findings Recent recommendations highlight the use of influenza, pneumococcal, and shingles vaccines in RA patients. Studies suggest influenza and pneumococcal vaccines are underutilized, but well tolerated in RA patients and generally immunogenic during DMARD use with the exception of rituximab. Though data for other nonlive vaccines are more limited, hepatitis B virus and human papilloma virus vaccines also appear well tolerated and immunogenic in this population. Live vaccines for shingles and yellow fever remain contraindicated in some RA patients; however, limited data suggest they might be well tolerated in certain individuals. Summary The review updates rheumatologists on the optimal use and timing of routine vaccinations in the care of RA.
AB - Purpose of review Rheumatoid arthritis (RA) patients experience increased infectious disease-related morbidity and mortality, and vaccinations represent an important element in their care. However, vaccine immunogenicity can be affected by disease-modifying antirheumatic drug (DMARD) therapy, such that vaccine choice and timing can be clinically challenging. We review the indications, safety, and immunogenicity of vaccines in the setting of RA. Recent findings Recent recommendations highlight the use of influenza, pneumococcal, and shingles vaccines in RA patients. Studies suggest influenza and pneumococcal vaccines are underutilized, but well tolerated in RA patients and generally immunogenic during DMARD use with the exception of rituximab. Though data for other nonlive vaccines are more limited, hepatitis B virus and human papilloma virus vaccines also appear well tolerated and immunogenic in this population. Live vaccines for shingles and yellow fever remain contraindicated in some RA patients; however, limited data suggest they might be well tolerated in certain individuals. Summary The review updates rheumatologists on the optimal use and timing of routine vaccinations in the care of RA.
KW - Influenza
KW - Pneumococcal pneumonia
KW - Rheumatoid arthritis
KW - Shingles
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=84961226593&partnerID=8YFLogxK
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U2 - 10.1097/BOR.0000000000000281
DO - 10.1097/BOR.0000000000000281
M3 - Review article
C2 - 26986246
AN - SCOPUS:84961226593
SN - 1040-8711
VL - 28
SP - 330
EP - 336
JO - Current opinion in rheumatology
JF - Current opinion in rheumatology
IS - 3
ER -