The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy

Curtis, Jeffrey R.; Cofield, Stacey S.; Bridges, S. Louis; Bassler, John; Deodhar, A.; Ford, Theresa Lawrence; Huffstutter, J. Eugene; Jankeel, Allen; Kivitz, Alan; Kamal, Shaila; Lindsey, Stephen; Messaoudi, Ilhem; Mendoza, Norma; Michaud, Kaleb; Mikuls, Ted R.; Ridley, David; Shergy, William; Siegel, S.A.R.; Winthrop, Kevin

doi:10.7326/m20-6928

Cited by 29 publications

(17 citation statements)

References 19 publications

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“…A randomized controlled trial with 617 patients on tumor necrosis factor-alpha inhibitors (NCT02538341) demonstrated a favorable safety of the live attenuated vaccine in this particular patient's group [99].…”

Section: Vaccinationmentioning

confidence: 99%

Herpes zoster: A Review of Clinical Manifestations and Management

Patil

Goldust

Wollina

2022

Viruses

218

123

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The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.

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Section: Vaccinationmentioning

confidence: 99%

Herpes zoster: A Review of Clinical Manifestations and Management

Patil

Goldust

Wollina

2022

Viruses

218

123

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“…The adjuvanted recombinant zoster vaccine (RZV) confirmed its efficacy in a post-hoc analysis of >50 and >70 years aged patients with pre-existing immune-mediated diseases, including RA, showing an average vaccine efficacy against HZ of 90% in the mixed population. Given the post-hoc nature of the analysis and that immunosuppression was an exclusion criterion of the trials, the real effect in actively treated patients is not yet clarified (44). Conversely the live attenuated zoster vaccine (ZVL) was tested in a RCT including >50 years aged patients on stable disease on TNFis, including a majority (57.6%) of RA (VERVE trial).…”

Section: Other Vaccinationsmentioning

confidence: 99%

“…(41,42). • HZ vaccination by the RZV is a safe and effective vaccine for patients with immune-mediated diseases, but also ZVL may be an option in TNFistreated patients with stable disease in the absence of an alternative vaccine (43,44).…”

Section: Other Vaccinationsmentioning

confidence: 99%

Novel insights into the management of rheumatoid arthritis: one year in review 2022

Garaffoni

Adinolfi²,

Bortoluzzi

et al. 2022

Clinical and Experimental Rheumatology

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New evidence for the treatment of rheumatoid arthritis (RA) has emerged during the last year. Specifically, updated guidelines on pharmacological and non-pharmacological management of RA have emphasised the necessity of global patient's care, and have shifted the role of some older drugs, such as glucocorticoids and methotrexate. In addition, the long-term safety of Janus kinase inhibitors was investigated and reinforced. With respect to the coronavirus-19 pandemic, reassuring data on the efficacy and safety of vaccinations in the RA population were acquired, as well as on the potential role of telemedicine in RA management. Machine learning prediction models and biomarkers development have emerged as promising innovations in the area of precision/personalised medicine, appearing to encourage future expansion. In this narrative review, the authors aim to give their specific point of view on the most relevant and potentially impacting novelties published during 2021 and early 2022 in the context of RA management.

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“…R. Curtis и соавт. [29] выполнили РПКИ по изучению LZV у 617 пациентов с РА, у которых лечение иФНО-α было начато не менее чем за 30 дней до рандомизации. Критерием включения для первых 100 больных было отсутствие терапии ГК в течение 30 дней до рандомизации и положительный титр IgG к вирусу HZ.…”

Section: вакцинация против Hz при ирвзunclassified

“…К завершению годичного наблюдения у 12 участников предполагалось развитие ОЛ (7 в группе LZV и 5 -плацебо); из них 8 были тестированы на наличие вируса HZ, все результаты были отрицательными. Четверо участников не тестировались: у 1 не было никаких видимых изменений кожи; у 2 с большой вероятностью имели место аллергические реакции, а не ОЛ; 1 был осмотрен местным врачом и не связывался с координационным центром для тестирования [29].…”

Section: вакцинация против Hz при ирвзunclassified

Vaccine Prophylaxis of Herpes Zoster In Rheumatic Diseases: Paradigm Revision and New Opportunities

Гриднева

Белов

Аронова

2022

A&Ch

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Background. The issues of vaccination against the herpesvirus infection are still important in rheumatological practice.This infection often develops in patients receiving immunosuppressive treatment, especially Janus kinase inhibitors (a class-specific adverse reaction) and genetically engineered biologics.The aim of this review is to highlight the current state of the issue of vaccination against Herpes zoster (HZ).Materials and Methods. 37 publications (4 domestic, 33 foreign) were analyzed, in which the mechanisms of pathogenesisand clinical features of herpesvirus infection in patients with immunodeficiency, both with and without immunoinflammatory rheumatic diseases (IIRD), the frequency and variety of post-vaccination reactions, complications and exacerbations of the course of IIRD were considered.Results. There is currently a trend towards reassessment of the rheumatological community's opinion about HZ vaccination, including live vaccine. Literature data allow us to express optimism regarding the effective prevention of herpes zoster in patients who plan to take drugs, primarily from the group of Janus kinase inhibitors. The advantages of the adjuvant recombinant subunit vaccine (Shingrix®) include the possibility of its use against the background of treatment with antirheumatic drugs without significant restrictions, as well as no need to postpone the initiation of the necessary therapy.Conclusions. Publications on the issues of HZ vaccination are few. It is necessary to conduct carefully controlled studies on the efficacy and safety of antiherpetic vaccines with an emphasis on the post-vaccination course of IIRD in patients with rheumatological profile, including in the Russian Federation.

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The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy

Cited by 29 publications

References 19 publications

Herpes zoster: A Review of Clinical Manifestations and Management

Herpes zoster: A Review of Clinical Manifestations and Management

Novel insights into the management of rheumatoid arthritis: one year in review 2022

Vaccine Prophylaxis of Herpes Zoster In Rheumatic Diseases: Paradigm Revision and New Opportunities

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