Bartalesi Filippo, Scirè Carlo, Requena-Méndez Ana, Abad Miguel Angel, Buonfrate Dora, Caporali Roberto, Conti Fabrizio, Diaz-Gonzalez Federico, Fernández-Espartero Cruz, Martinez-Fernandez Carmen, Mascarello Marta, Generali Elena, Minisola Giovanni, Morrone Aldo, Muñoz José, Richi Patricia, Sakellariou Gariffalia, Salas Coronas Joaquin, Spinicci Michele, Castelli Francesco, Bartoloni Alessandro, Bisoffi Zeno, Gimenez-Sanchez Francisco, Muñoz-Fernandez Santiago, Matucci-Cerinic Marco
SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy.
Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Epidemiology Unit, Italian Society for Rheumatology, Milano, Italy.
Clin Exp Rheumatol. 2017 Sep-Oct;35(5):752-765. Epub 2017 May 8.
Inflammatory arthritis needs infectious disease screening before starting a biologic agent, however, few data are known about migrant patients, who represent a peculiar population which requires a multidisciplinary approach among international health specialists and should also be considered by health authorities. For this reason, the Italian and Spanish Societies of Rheumatology (SIR and SER) and Tropical Medicine (SIMET and SEMTSI) promoted a multidisciplinary task force in order to produce specific recommendations about screening and advices to be considered in migrant patients with inflammatory arthritis candidate to receive biological therapy, according to their geographical origin.
The experts provided a prioritised list of research questions and the eligible spectrum of inflammatory arthritis, biologic drugs and infectious disease were defined in order to perform a systematic literature review. A search was made in Medline, Embase and Cochrane library, updated to March 2015. Ubiquitous infections and HBV, HCV, HIV and tuberculosis that are already considered in national and international recommendations, were not included. The strength of each recommendation was determined.
The task force members agreed on 7 overarching principles. The risk of reactivation of selected potentially latent infectious disease was addressed in migrants with inflammatory arthritis candidates for biologics was considered and 15 potentially relevant infections were identified.
Fifteen disease-specific recommendations were formulated on the basis of high level of agreement among the experts panel.
炎性关节炎在开始使用生物制剂前需要进行传染病筛查，然而，关于移民患者的数据却很少，他们是一个特殊的群体，需要国际卫生专家采取多学科方法，卫生当局也应予以关注。因此，意大利和西班牙风湿病学会（SIR和SER）以及热带医学学会（SIMET和SEMTSI）发起了一个多学科特别工作组，以便根据移民患者的地理来源，就筛查和建议提出具体建议，供那些有接受生物治疗可能的炎性关节炎移民患者参考。
专家们提供了一份优先研究问题清单，并确定了炎性关节炎、生物药物和传染病的适用范围，以便进行系统的文献综述。检索了截至2015年3月更新的Medline、Embase和Cochrane图书馆。国家和国际建议中已考虑的常见感染以及乙肝、丙肝、艾滋病毒和结核病未被纳入。确定了每项建议的力度。
特别工作组成员就7项总体原则达成一致。考虑了有接受生物制剂可能的炎性关节炎移民中选定的潜在潜伏性传染病再激活风险，并确定了15种潜在相关感染。
根据专家小组的高度共识，制定了15项针对具体疾病的建议。
