Martin Charlotte, Muls Vinciane, Brasseur Céline, Meric de Bellefon Laurent, Lam Hoai Xuan-Lan, Vanderhilst Jeroen, Delforge Marc, Di Romana Silvana
Department of Infectious Diseases.
Department of Gastroenterology.
Rheumatol Adv Pract. 2021 Nov 27;5(3):rkab092. doi: 10.1093/rap/rkab092. eCollection 2021.
Patients with immune-mediated inflammatory disease (IMID) present an increased risk of infection. Here, we present the concept of a preventive consultation called ImmunoStart and the first results of its implementation in the care pathway of patients with IMID.
Relevant information about vaccination history, tuberculosis exposure and other infectious risks were collected through blood sampling, complete anamnesis, chest X-ray and Mantoux test. During the ImmunoStart consultation, vaccination schedules, specific treatments and risk considerations were discussed.
Between October 2016 and February 2020, 437 patients were seen at an ImmunoStart consultation, mainly referred by rheumatologists (56%), dermatologists (25%) and gastroenterologists (18%). A total of 421 (96%) patients needed at least one vaccine (a mean of 3.3 vaccines per patient). Live attenuated vaccine was indicated for 45 patients (10%), requiring them to reduce or interrupt their immunosuppressive drug(s). Ninety-two patients (21%) were treated for latent tuberculosis infection.
This preventive consultation provides a centralized and systematic setting for the direct management of patients with IMID in need of vaccination, treatment of latent disease and specific advice regarding their immunomodulating treatments.
免疫介导的炎症性疾病（IMID）患者感染风险增加。在此，我们提出一种名为ImmunoStart的预防性咨询概念及其在IMID患者护理路径中实施的初步结果。
通过采血、完整的病史采集、胸部X光和结核菌素试验收集有关疫苗接种史、结核暴露和其他感染风险的相关信息。在ImmunoStart咨询期间，讨论了疫苗接种计划、特定治疗方法和风险考量。
2016年10月至2020年2月期间，共有437名患者接受了ImmunoStart咨询，主要由风湿病学家（56%）、皮肤科医生（25%）和胃肠病学家（18%）转诊。共有421名（96%）患者需要至少一种疫苗（每位患者平均3.3种疫苗）。45名（10%）患者需要接种减毒活疫苗，这要求他们减少或中断免疫抑制药物。92名（21%）患者接受了潜伏性结核感染治疗。
这种预防性咨询为需要接种疫苗、治疗潜伏性疾病以及就其免疫调节治疗提供特定建议的IMID患者的直接管理提供了一个集中且系统的环境。
