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. 2021 Nov 27;5(3):rkab092.
doi: 10.1093/rap/rkab092. eCollection 2021.

ImmunoStart: preparing patients for immunosuppression

Charlotte Martin  1 , Vinciane Muls  2 , Céline Brasseur  3 , Laurent Meric de Bellefon  3 , Xuan-Lan Lam Hoai  4 , Jeroen Vanderhilst  5 , Marc Delforge  1 , Silvana Di Romana  3
Affiliations

ImmunoStart: preparing patients for immunosuppression

Charlotte Martin et al. Rheumatol Adv Pract. .

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: immune-mediated inflammatory disease; immunosuppression; latent; prevention; screening; vaccination.

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