Inmunización y quimioprofilaxis en pacientes con artritis reumatoide

Abstract

The incidence of severe infections has been estimated to be higher in patients with rheumatoid arthritis. In particular, respiratory infections are up to twice as frequent in these patients as in the general population, which often increases mortality due to immune disorders related to the disease itself and to the immunosuppressive treatment. Nowadays, some of these infections can be prevented by vaccines, which provide a window of opportunity for prophylaxis and for the prevention of complications arising from infection.

The most widely used vaccines in rheumatic diseases are the pneumococcal and influenza vaccines, which are recommended in vaccination guidelines. The data accumulated on the safety and efficacy of these vaccines support their use in patients with chronic autoimmune or inflammatory diseases. Immunization recommendations for this population should be applied in our daily clinical practice, as the evidence is sufficiently strong to encourage general vaccination against influenza, pneumococcus and hepatitis B in patients with rheumatic diseases. Screening strategies for tuberculosis, with the use of chemoprophylaxis if required, should also be applied in rheumatoid arthritis patients receiving immunosuppressive therapy.