Talarico Rosaria, Ramirez Giuseppe Alvise, Barreira Sofia C, Cardamone Chiara, Triggianese Paola, Aguilera Silvia, Andersen Jeanette, Avcin Tadej, Benistan Karelle, Bertsias George, Bortoluzzi Alessandra, Bouillot Coralie, Bulina Inita, Burmester Gerd R, Callens Steven, Carreira Patricia E, Cervera Ricard, Cutolo Maurizio, Damian Laura, Della-Torre Emanuel, Faria Raquel, Fonseca João E, Galetti Ilaria, Hachulla Eric, Iaccarino Luca, Jacobsen Søren, Khmelinskii Nikita, Limper Maarten, Marinello Diana, Meyer Alain, Moroncini Gianluca, Nagy Gyorgy, Olesinska Marzena, Pamfil Cristina, Pileckyte Margarita, Pistello Mauro, Rednic Simona, Richez Christophe, Romão Vasco C, Schneider Matthias, Sciascia Savino, Scirè Carlo Alberto, Simonini Gabriele, Smith Vanessa, Sulli Alberto, Tani Chiara, Tas Sander W, Tincani Angela, Vonk Madelon C, Tektonidou Maria, Mosca Marta
Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, and Università Vita-Salute San Raffaele, Milan, Italy.
Clin Exp Rheumatol. 2023 Mar;41(3):543-553. doi: 10.55563/clinexprheumatol/jpargp. Epub 2023 Mar 14.
Recent studies have shown that people who are immunocompromised may inadvertently play a role in spurring the mutations of the virus that create new variants. This is because some immunocompromised individuals remain at risk of getting COVID-19 despite vaccination, experience more severe disease, are susceptible to being chronically infected and remain contagious for longer if they become infected and considering that immunocompromised individuals represent approximately 2% of the overall population, this aspect should be carefully considered. So far, some autoimmune rheumatic disease (ARD) patients with COVID-19 have been treated with antiviral therapies or anti-SARS-CoV-2 antibody products. However, there is no homogeneous approach to these treatment strategies. This issue was addressed within the European Reference Network (ERN) on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ReCONNET) in a discussion among experts and patient's representatives in the context of the rare and complex connective tissue diseases (rCTDs) covered by the Network. ERN ReCONNET is one of the 24 ERNs launched by the European Commission in 2017 with the aim of tackling low prevalence and rare diseases that require highly specialised treatment and promoting concentration of knowledge and resources through virtual networks involving healthcare providers (HCPs) across the European Union (EU). Considering the urgent need to provide guidance not only to the rCTDs community, but also to the whole ARDs community, a multidisciplinary Task Force, including expert clinicians and European Patient Advocacy Group (ePAG) Advocates, was created in the framework of ERN ReCONNET with the aim of developing overarching principles (OP) and points-to-consider (PtC) on a homogenous approach to treat immunocompromised patients with ARDs (with a particular focus on CTDs) affected by COVID-19 using antiviral therapies and anti-SARS-CoV-2 antibody products. The present work reports the final OP and PtC agreed by the Task Force.
最近的研究表明，免疫功能低下的人可能在无意中促使病毒发生突变，从而产生新的变种。这是因为一些免疫功能低下的人尽管接种了疫苗，但仍有感染新冠病毒的风险，会经历更严重的疾病，容易受到慢性感染，如果被感染，传染性会持续更长时间。鉴于免疫功能低下的人约占总人口的2%，这一方面应予以仔细考虑。到目前为止，一些感染新冠病毒的自身免疫性风湿病（ARD）患者已接受抗病毒疗法或抗SARS-CoV-2抗体产品治疗。然而，这些治疗策略并没有统一的方法。欧洲罕见和复杂结缔组织及肌肉骨骼疾病参考网络（ReCONNET）在专家和患者代表就该网络所涵盖的罕见和复杂结缔组织疾病（rCTD）进行的讨论中，探讨了这个问题。ERN ReCONNET是欧盟委员会于2017年发起的24个ERN之一，旨在应对需要高度专业化治疗的低发病率和罕见疾病，并通过涉及欧盟各地医疗服务提供者（HCP）的虚拟网络促进知识和资源的集中。考虑到不仅需要为rCTD群体，也需要为整个ARD群体提供指导的迫切需求，在ERN ReCONNET的框架内成立了一个多学科特别工作组，包括专家临床医生和欧洲患者倡导组织（ePAG）倡导者，目的是制定总体原则（OP）和要点考虑（PtC），以采用统一方法，使用抗病毒疗法和抗SARS-CoV-2抗体产品治疗受新冠病毒影响的免疫功能低下的ARD患者（尤其关注CTD）。本工作报告了特别工作组商定的最终OP和PtC。
