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麻腮风疫苗加强免疫在幼年特发性关节炎患者中的安全性:一项长期随访研究。

Safety of Measles-Mumps-Rubella booster vaccination in patients with juvenile idiopathic arthritis: A long-term follow-up study.

机构信息

Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Pediatrics, Carmel Medical Center, Technion Faculty of Medicine, Haifa, Israel.

Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.

出版信息

Vaccine. 2023 May 2;41(18):2976-2981. doi: 10.1016/j.vaccine.2023.03.074. Epub 2023 Apr 7.

Abstract

OBJECTIVES

To study short and long-term disease activity and vaccine-related adverse events in a cohort of JIA patients who received the live attenuated measles-mumps-rubella (MMR) booster vaccine while being treated with immunosuppressive and immunomodulatory therapies.

METHODS

A retrospective study was performed in the UMC Utrecht, clinical and therapeutic data were collected from electronic medical records for two visits before and two visits after the MMR booster vaccine of JIA patients. Drug therapy was collected and adverse events related to the vaccine were requested from the patients during clinical visits or by short phone interviews. Associations between MMR booster vaccination and the active joint count, physician global assessment of disease activity, patient-reported visual analogue scale (VAS) for well-being and clinical Juvenile Arthritis Disease Activity Score (cJADAS) were analyzed using multivariable linear mixed effects analyses.

RESULTS

A total of 186 JIA patients were included in the study. At the time of vaccination, 51% of the patients used csDMARD and 28% used bDMARD therapy. Overall, adjusted disease activity scores after MMR booster vaccination were not significantly different compared to pre-vaccination. Mild adverse events related to the MMR booster were reported for 7% of the patients. No serious adverse events were reported.

CONCLUSION

MMR booster vaccination was safe and did not worsen disease activity during long-term follow-up in a large cohort of JIA patients being treated with both csDMARDs and biological DMARDs.

摘要

目的

研究在接受免疫抑制和免疫调节治疗的幼年特发性关节炎(JIA)患者中,接种减毒麻疹-腮腺炎-风疹(MMR)加强疫苗后的短期和长期疾病活动和疫苗相关不良事件。

方法

在乌得勒支大学医学中心(UMC Utrecht)进行了一项回顾性研究,从电子病历中收集了 JIA 患者接种 MMR 加强疫苗前后两次就诊的临床和治疗数据。收集药物治疗情况,并在临床就诊时或通过简短电话访谈向患者询问与疫苗相关的不良事件。使用多变量线性混合效应分析评估 MMR 加强疫苗接种与活跃关节计数、医生对疾病活动的总体评估、患者报告的健康视觉模拟量表(VAS)和临床幼年特发性关节炎疾病活动评分(cJADAS)之间的关联。

结果

共有 186 名 JIA 患者纳入研究。在接种疫苗时,51%的患者使用 csDMARD,28%的患者使用 bDMARD 治疗。总体而言,与接种前相比,接种 MMR 加强疫苗后的调整疾病活动评分无显著差异。7%的患者报告了与 MMR 加强疫苗相关的轻度不良事件。未报告严重不良事件。

结论

在接受 csDMARD 和生物 DMARD 治疗的大量 JIA 患者中,MMR 加强疫苗接种是安全的,并且在长期随访期间不会加重疾病活动。

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