Updates in vaccination: Recommendations for adult inflammatory bowel disease patients

Chaudrey, Khadija; Salvaggio, Michelle; Ahmed, Aftab; Mahmood, Sultan; Ali, Tauseef

doi:10.3748/wjg.v21.i11.3184

Cited by 26 publications

(31 citation statements)

References 66 publications

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“…Healthcare maintenance comprises interventions to prevent illness and promote fitness and health. In IBD patients, several preventive interventions are recommended (Table 2) [77][78][79]. However, in one British American study, IBD patients received preventive services at a lower rate compared to control individuals [80].…”

Section: Healthcare Maintenancementioning

confidence: 99%

Clinical manifestations, pathophysiology, treatment and outcome of inflammatory bowel diseases in older people

et al. 2018

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Approximately 10-20% of inflammatory bowel disease (IBD) cases are diagnosed after 60 years of age. Due to the high prevalence of conditions mimicking IBD at older age - including bowel disease associated with non-steroidal anti-inflammatory drugs, diverticulitis, and microscopic colitis - differential diagnosis of IBD among older adults is frequently delayed. Late-onset IBD is characterized by a predominance of colonic disease and an overall milder disease course; disease progression and new intestinal manifestations are rare. However, older patients are less able to tolerate inflammation and their risk of mortality from severe disease is increased. Management of late-onset IBD has been insufficiently studied since older adults are underrepresented in clinical trials and specific problems of older patients such as incontinence have not been addressed. To date, treatment generally follows the same principles as in the younger. However, older patients are at higher risk of severe adverse effects of the disease and its treatments, including bone and muscle loss, infections and lymphoma. Therefore, the safety profile of a given drug is of paramount importance in older patients with IBD. Colectomy with ileo-anal pouch anastomosis for refractory ulcerative colitis can be performed safely, although functional results may be inferior to those in middle-aged patients. To decrease mortality among older patients, a timely surgical intervention is important. Patients with late-onset IBD frequently develop colorectal carcinoma within 8 years of diagnosis; therefore, colorectal cancer screening immediately after diagnosis should be considered. Further, the clinical care of older patients with IBD needs to extend to overall health, including nutrition, vaccination, bone, muscle and mental health.

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Section: Healthcare Maintenancementioning

confidence: 99%

Clinical manifestations, pathophysiology, treatment and outcome of inflammatory bowel diseases in older people

et al. 2018

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“…Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized (3) . Some of the contributing factors are lack of awareness about the importance of vaccination, misperception about the safety of vaccines in immunocompromised patients, fear of side effects, the uncertain role of the gastroenterologist in contrast to the primary care physician (5) and the lack of knowledge by the gastroenterologists about the appropriate immunization for IBD patients (3) .…”

Section: Introductionmentioning

confidence: 99%

Immunization Status of Patients With Inflammatory Bowel Disease

Strasse

Jamur

Marques

et al. 2019

Arq. Gastroenterol.

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BACKGROUND: Treatment for inflammatory bowel disease (IBD) includes a variety of immunosuppressants and biological agents, which increase the risk of infections due to altered cellular and humoral immunity. Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized. OBJECTIVE: Analyze the immunization status of patients with IBD and confront it with the current recommendations to verify if the immunization guidelines are being followed correctly. METHODS: Analytical cross-sectional study including 239 IBD patients being regularly followed in the Gastroenterology Service from Hospital de Clínicas da Universidade Federal do Paraná, which were subjected to a survey about their relevant demographic data and immunization status. RESULTS: The amount of patients that declared being unaware of their immunization status is high - between 34.3% (Tdap) and 52% (meningococcal) - excepting IIV, hepatitis B and HPV. The vaccines with the largest rates of patients declaring to have taken it are inactivated influenza vaccine (72.4%), BCG (55.3%), hepatitis B (48.3%), measles, mumps and rubella vaccine (43.8%) and DTaP (43%). The vaccines with the lowest rates of patients declaring to have taken it are Haemophilus influenza type b (0.8%), herpes zoster (2.1%) and HPV (3.4%). Patients that are being treated or have been treated with biological therapy have the largest immunization coverage for inactivated influenza vaccine (81%) and PPSV23 (25.9%), also they have the largest awareness rates for those vaccines. CONCLUSION: Although being a specialized service linked to a university hospital, vaccination coverage and patients’ awareness rates proved to be below the desirable level. Vaccination and recovery of the immunization history is recommended immediately after the diagnosis of IBD, regardless of the use of biological agents. Those findings support the need of implementing hospital guidelines and constantly verifying its application by the multidisciplinary team in specialized services in IBD.

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“…In this study, we defined immunosuppressive therapy as one offered to patient with a medical history of i) prednisolone administration exceeding 20 mg per day for the equivalent of 2 weeks or more, ii) immunosuppressant drugs (including cyclosporine and tacrolimus), iii) immunomodulator drugs (including 6-mercaptopurine, azathioprine and methotrexate) or iv) biologic therapies (including infliximab and adalimumab) for UC treatment. According to a previous report, these therapies induce an immunocompromised state in inflammatory bowel disease patients (15).…”

Section: Methodsmentioning

confidence: 99%

Uselessness of Serum p53 Antibody for Detecting Colitis-associated Cancer in the Era of Immunosuppressive Therapy

Toritani

Kimura

Kunisaki

et al. 2020

In Vivo

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Background/Aim: The present study examined the utility of serum p53 antibody (Ab) for detecting colitisassociated cancer (CAC) in the era of immunosuppressive therapy. Patients and Methods: Two hundred and fifty patients were analyzed, 219 had no carcinoma or dysplasia (Group non-CAC), and 31 had carcinoma or dysplasia (Group CAC). Serum p53 Abs were detected with an enzyme-linked immunosorbent assay. Immunohistochemical detection was performed in Group CAC. Results: Immunosuppressive therapy was performed in 98.1% of Group non-CAC and 80.6% of Group CAC. There were no differences in serum p53 Abs positivity between p=0.30). p53 staining positivity was noted in 90.3% of Group CAC, and the rate of serum p53 positivity was significantly lower in patients with immunosuppressive therapy than in those without in Group CAC (0.0% vs. 16.7%, p=0.04). Conclusion: The utility of serum p53 Ab for detecting CAC is dubious in the era of immunosuppressive therapy.

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Updates in vaccination: Recommendations for adult inflammatory bowel disease patients

Cited by 26 publications

References 66 publications

Clinical manifestations, pathophysiology, treatment and outcome of inflammatory bowel diseases in older people

Clinical manifestations, pathophysiology, treatment and outcome of inflammatory bowel diseases in older people

Immunization Status of Patients With Inflammatory Bowel Disease

Uselessness of Serum p53 Antibody for Detecting Colitis-associated Cancer in the Era of Immunosuppressive Therapy

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