Kuwait Recommendations on Vaccine Use in People with Inflammatory Rheumatic Diseases

Abstract

People with IRD are at increased risk of infection, and in 2011 EULAR made general recommendations for vaccination in these patients. Global and European perspectives are important, but they cannot accurately reflect the individual situations of patients in different countries and regions. Based on our clinical experience and opinions, we have sought to tailor the original EULAR recommendations to include advice for vaccination with new agents approved in the intervening years-including the new class of targeted synthetic disease-modifying antirheumatic drugs. We have also considered the specific demographic needs of patients in local populations in the Gulf region. The resulting 16 recommendations are grouped into four main categories covering general vaccination guidelines and best-practice for all patients with IRD, followed by a set of recommended vaccines against specific pathogens. The last two categories include recommendations for certain patient subgroups with defined risks and for patients who wish to travel.

Figure 1

Recommendations for HBV screening and prophylaxis in patients to be administered with bDMARDs, tsDMARDs, or >7.5 mg/day prednisolone [29]. ¹Treatment period is up until the patient becomes HBsAg negative in patients with chronic hepatitis B (liver disease), and antiviral treatment should continue 6–12 months after immunosuppressive and/or bDMARD treatment is completed in patients without liver disease (12 months for rituximab). ²If rituximab is to be administered, antiviral prophylaxis should be given, even if patients are negative for HBV DNA (−). ³HBV DNA is repeated once in 1–6 months (3 months on average). Figure reproduced with permission from the European Journal of Rheumatology.

Box 1

Inflammatory rheumatic diseases [8].

Box 2

Vaccine overview.