2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases.

Autor: Bass AR; Hospital for Special Surgery and Weill Cornell Medicine, New York, New York., Chakravarty E; Oklahoma Medical Research Foundation, Oklahoma City., Akl EA; American University of Beirut, Beirut, Lebanon., Bingham CO; Johns Hopkins Medicine, Baltimore, Maryland., Calabrese L; Cleveland Clinic Foundation, Cleveland, Ohio., Cappelli LC; Johns Hopkins Medicine, Baltimore, Maryland., Johnson SR; Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada., Imundo LF; Columbia University Irving Medical Center, New York, New York., Winthrop KL; Oregon Health & Science University, Portland., Arasaratnam RJ; VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas., Baden LR; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts., Berard R; Children's Hospital, London Health Sciences Centre, London, Ontario, Canada., Bridges SL Jr; Hospital for Special Surgery and Weill Cornell Medicine, New York, New York., Cheah JTL; University of Massachusetts Chan Medical School, Worcester., Curtis JR; University of Alabama at Birmingham., Ferguson PJ; University of Iowa Carver College of Medicine, Iowa City., Hakkarinen I; Greenbelt, Maryland., Onel KB; Hospital for Special Surgery and Weill Cornell Medicine, New York, New York., Schultz G; Athens, Ohio., Sivaraman V; The Ohio State University and Nationwide Children's Hospital, Columbus., Smith BJ; Florida State University College of Medicine, Tallahassee., Sparks JA; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts., Vogel TP; Baylor College of Medicine, Houston, Texas., Williams EA; The Permanente Medical Group, Union City, California., Calabrese C; Cleveland Clinic Foundation, Cleveland, Ohio., Cunha JS; Brown University, Brown Physicians Inc., and Providence Veterans Affairs Medical Center, East Providence, Rhode Island., Fontanarosa J; ECRI Institute, Plymouth Meeting, Pennsylvania., Gillispie-Taylor MC; Baylor College of Medicine, Houston, Texas., Gkrouzman E; University of Massachusetts Chan Medical School, Worcester., Iyer P; University of California Irvine Medical Center, Orange., Lakin KS; Hospital for Special Surgery and Weill Cornell Medicine, New York, New York., Legge A; Dalhousie University and QEII Health Sciences Centre, Halifax, Nova Scotia, Canada., Lo MS; Boston Children's Hospital, Boston, Massachusetts., Lockwood MM; Georgetown University Hospital, Washington, DC., Sadun RE; Duke University, Durham, North Carolina., Singh N; University of Washington, Seattle., Sullivan N; ECRI Institute, Plymouth Meeting, Pennsylvania., Tam H; British Columbia Children's Hospital, Vancouver, British Columbia, Canada., Turgunbaev M; American College of Rheumatology, Atlanta, Georgia., Turner AS; American College of Rheumatology, Atlanta, Georgia., Reston J; ECRI Institute, Plymouth Meeting, Pennsylvania.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2023 Mar; Vol. 75 (3), pp. 333-348. Date of Electronic Publication: 2023 Jan 04.
DOI: 10.1002/art.42386
Abstrakt: Objective: To provide evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases (RMDs).
Methods: This guideline follows American College of Rheumatology (ACR) policy guiding management of conflicts of interest and disclosures and the ACR guideline development process, which includes the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. It also adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. A core leadership team consisting of adult and pediatric rheumatologists and a guideline methodologist drafted clinical population, intervention, comparator, outcomes (PICO) questions. A review team performed a systematic literature review for the PICO questions, graded the quality of evidence, and produced an evidence report. An expert Voting Panel reviewed the evidence and formulated recommendations. The panel included adult and pediatric rheumatology providers, infectious diseases specialists, and patient representatives. Consensus required ≥70% agreement on both the direction and strength of each recommendation.
Results: This guideline includes expanded indications for some vaccines in patients with RMDs, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy. Safe approaches to the use of live attenuated vaccines in patients taking immunosuppressive medications are also addressed. Most recommendations are conditional and had low quality of supporting evidence.
Conclusion: Application of these recommendations should consider patients' individual risk for vaccine-preventable illness and for disease flares, particularly if immunosuppressive medications are held for vaccination. Shared decision-making with patients is encouraged in clinical settings.
(© 2023 American College of Rheumatology.)
Databáze: MEDLINE
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