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关节内注射皮质类固醇对疫苗效力的影响:当前概念综述

The Effect of Intra-articular Corticosteroid Injections on Vaccine Efficacy: A Current Concepts Review.

作者信息

Kreulen R Timothy, Margalit Adam, Miller Andrew S, Srikumaran Uma, Wilckens John H, Laporte Dawn

出版信息

Arch Bone Jt Surg. 2023;11(5):306-312. doi: 10.22038/ABJS.2023.68418.3263.


DOI:10.22038/ABJS.2023.68418.3263
PMID:37265524
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10231920/
Abstract

Orthopedic surgeons commonly perform corticosteroid injections. These injections have systemic side effects, including suppression of the hypothalamic-pituitary adrenal axis. Due to this suppression, there is a theoretical risk of corticosteroid injections affecting the efficacy of the novel COVID-19 vaccines. This potential interaction led the American Academy of Orthopedic Surgeons to recommend, "avoiding musculoskeletal corticosteroid injections for two weeks before and one week after COVID vaccine administration." This review examines the literature underlying this recommendation. An extensive literature review was performed through PubMed, MEDLINE, and Google Scholar from database inception to May 2022. Keywords searched were COVID, coronavirus, vaccine, vaccination, steroids, and corticosteroids. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. There is no definitive evidence that corticosteroid injections affect COVID-19 vaccine efficacy or increase the risk of contracting COVID. The authors recommend orthopedic surgeons follow the AAOS guidelines, which recommend avoiding injections two weeks before and one week following COVID vaccine administration. Additional research is needed to better define this theoretical risk, especially since there is good evidence that injections suppress the hypothalamic-pituitary-adrenal-axis.

摘要

骨科医生经常进行皮质类固醇注射。这些注射会产生全身性副作用,包括抑制下丘脑-垂体-肾上腺轴。由于这种抑制作用,理论上存在皮质类固醇注射影响新型冠状病毒肺炎(COVID-19)疫苗效力的风险。这种潜在的相互作用促使美国骨科医师学会建议,“在接种COVID疫苗前两周和接种后一周避免进行肌肉骨骼皮质类固醇注射”。本综述探讨了这一建议背后的文献依据。通过PubMed、MEDLINE和谷歌学术进行了广泛的文献综述,检索时间从数据库建立至2022年5月。检索关键词为COVID、冠状病毒、疫苗、接种、类固醇和皮质类固醇。搜索结果包括用英文撰写的文章,涵盖综述、病例系列、实证研究和基础科学文章。没有确凿证据表明皮质类固醇注射会影响COVID-19疫苗效力或增加感染COVID的风险。作者建议骨科医生遵循美国骨科医师学会(AAOS)的指南,该指南建议在接种COVID疫苗前两周和接种后一周避免注射。需要进行更多研究以更好地界定这种理论风险,特别是因为有充分证据表明注射会抑制下丘脑-垂体-肾上腺轴。

相似文献

[1]
The Effect of Intra-articular Corticosteroid Injections on Vaccine Efficacy: A Current Concepts Review.

Arch Bone Jt Surg. 2023

[2]
Do Corticosteroid Injections for the Treatment of Pain Influence the Efficacy of mRNA COVID-19 Vaccines?

Pain Med. 2021-4-20

[3]
The systemic immunosuppressive effects of peripheral corticosteroid injections: A narrative review of the evidence in the context of COVID-19.

Musculoskeletal Care. 2022-9

[4]
Foot and Ankle Injections in Athletes.

Sports Health. 2022

[5]
Do Corticosteroid Injections for the Treatment of Pain Influence the Efficacy of Adenovirus Vector-Based COVID-19 Vaccines?

Pain Med. 2021-6-4

[6]
Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.

Cochrane Database Syst Rev. 2022-2-1

[7]
Steroid injections in pain management: influence on coronavirus disease 2019 vaccines.

Korean J Pain. 2022-1-1

[8]
Epidural corticosteroid injections for lumbosacral radicular pain.

Cochrane Database Syst Rev. 2020-4-9

[9]
Intra-articular viscosupplementation with hylan g-f 20 to treat osteoarthritis of the knee: an evidence-based analysis.

Ont Health Technol Assess Ser. 2005

[10]
Impact of Clinical Practice Guidelines on Use of Intra-Articular Hyaluronic Acid and Corticosteroid Injections for Knee Osteoarthritis.

J Bone Joint Surg Am. 2018-5-16

本文引用的文献

[1]
The systemic immunosuppressive effects of peripheral corticosteroid injections: A narrative review of the evidence in the context of COVID-19.

Musculoskeletal Care. 2022-9

[2]
A New Consideration for Corticosteroid Injections: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2/COVID-19) Vaccination.

J Hand Surg Am. 2022-1

[3]
Overview of the Main Anti-SARS-CoV-2 Vaccines: Mechanism of Action, Efficacy and Safety.

Infect Drug Resist. 2021-8-31

[4]
Suboptimal Response to Coronavirus Disease 2019 Messenger RNA Vaccines in Patients With Hematologic Malignancies: A Need for Vigilance in the Postmasking Era.

Open Forum Infect Dis. 2021-6-30

[5]
Occurrence of severe COVID-19 in vaccinated transplant patients.

Kidney Int. 2021-8

[6]
Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia.

Blood. 2021-6-10

[7]
Immunogenicity of a Single Dose of SARS-CoV-2 Messenger RNA Vaccine in Solid Organ Transplant Recipients.

JAMA. 2021-5-4

[8]
Recommendations and Guidance for Steroid Injection Therapy and COVID-19 Vaccine Administration from the American Society of Pain and Neuroscience (ASPN).

J Pain Res. 2021-3-5

[9]
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine.

N Engl J Med. 2021-2-4

[10]
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine.

N Engl J Med. 2020-12-31

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