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接受免疫抑制治疗(包括生物制剂)的银屑病患者的疫苗接种状况

[Vaccination status in psoriasis patients on immunosuppressant therapy (including biologics)].

作者信息

Bonhomme A, Fréling E, Reigneau M, Poreaux C, Valois A, Truchetet F, Barbaud A, Schmutz J-L

机构信息

Service de dermatologie, hôpitaux de Brabois, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.

Service de dermatologie, hôpitaux de Brabois, CHU de Nancy, 6, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.

出版信息

Ann Dermatol Venereol. 2017 Feb;144(2):92-99. doi: 10.1016/j.annder.2016.09.035. Epub 2016 Oct 19.

Abstract

OBJECTIVES

To evaluate the vaccine coverage of psoriasis patients prior to initiating or changing immunosuppressant therapy, and to verify that the prescribed vaccines have been administered.

PATIENTS AND METHODS

We conducted a bi-centre, observational, cross-sectional study over 9 months. Psoriasis patients in whom immunosuppressant therapy (comprising cyclosporine, methotrexate, etanercept, infliximab, adalimumab or ustekinumab) was indicated were included. Medical history, previous treatments, vaccination status, viral serology results (for hepatitis B, measles, and chickenpox), and reasons for non-vaccination were assessed via questionnaire.

RESULTS

Sixty-eight patients were included. One third brought their immunization records. Overall, 54.4% had already received immunosuppressant therapy; of these, 9 were up to date for influenza and 3 were up to date for pneumococcus. Only one patient was up to date for all of the recommended vaccinations. A total of 61% of patients were seronegative for hepatitis B. The following vaccines were updated: DTP (in 2 patients), DTP-pertussis (12), influenza (22), pneumococcus (45), and hepatitis B (6). None of the three patients with plans to travel to yellow fever-endemic countries had been vaccinated. In all, 53 (78%) stated that they had already had chickenpox and 43 (63.2%) stated that they had had one of the following three diseases: measles, rubella, or mumps. Fifty-two patients were serologically tested for chickenpox, and 98% were immunized. The most common reasons for not updating the immunization schedule were the absence of any notification or proposal by the patient's doctor and oversight.

CONCLUSION

This study should help raise awareness among patients and health professionals concerning the new vaccination recommendations for a population particularly at risk of infection.

摘要

目的

评估银屑病患者在开始或改变免疫抑制治疗前的疫苗接种覆盖率,并核实所开疫苗是否已接种。

患者与方法

我们进行了一项为期9个月的双中心观察性横断面研究。纳入了需要进行免疫抑制治疗(包括环孢素、甲氨蝶呤、依那西普、英夫利昔单抗、阿达木单抗或乌司奴单抗)的银屑病患者。通过问卷调查评估病史、既往治疗、疫苗接种状况、病毒血清学结果(针对乙肝、麻疹和水痘)以及未接种疫苗的原因。

结果

纳入68例患者。三分之一的患者带来了免疫接种记录。总体而言,54.4%的患者已经接受了免疫抑制治疗;其中,9例流感疫苗接种及时,3例肺炎球菌疫苗接种及时。只有1例患者所有推荐疫苗接种均及时。共有61%的患者乙肝血清学检测呈阴性。以下疫苗进行了补种:白百破疫苗(2例患者)、白百破-百日咳疫苗(12例)、流感疫苗(22例)、肺炎球菌疫苗(45例)和乙肝疫苗(6例)。计划前往黄热病流行国家的3例患者均未接种疫苗。共有53例(78%)表示他们已经患过水痘,43例(63.2%)表示他们患过以下三种疾病中的一种:麻疹、风疹或腮腺炎。52例患者进行了水痘血清学检测,98%已获得免疫。未更新免疫接种计划的最常见原因是患者的医生未进行任何通知或建议以及疏忽。

结论

本研究应有助于提高患者和卫生专业人员对这一特别易感染人群新疫苗接种建议的认识。

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