ImmunoStart: preparing patients for immunosuppression. Issue 3 (27th November 2021)

• Record Type: Journal Article
• Authors: Martin, Charlotte; Muls, Vinciane; Brasseur, Céline; Meric de Bellefon, Laurent; Lam Hoai, Xuan-Lan; Vanderhilst, Jeroen; Delforge, Marc; Di Romana, Silvana
• Is Part Of: Rheumatology advances in practice. Volume 5:Issue 3(2021)
• Publication Date: 2021-11-27
• Subjects: immune-mediated inflammatory disease -- prevention -- immunosuppression -- vaccination -- screening -- latent; Rheumatology -- Periodicals; Rheumatology; Rheumatic Diseases; Rheumatology; Periodicals; Electronic journals; Periodical; 616.723005
• DOI: 10.1093/rap/rkab092
• Languages: English
• ISSNs: 2514-1775

Abstract

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.