MEDICAL INSIDER
DR. CORA LIM
FOR SEPTEMBER 10, 2023
Managing patients with autoimmune inflammatory rheumatic diseases
The reality is that patients with autoimmune inflammatory rheumatic diseases (AIIRD)
need to get special attention as they have a huge risk of infections, linked to the
underlying autoimmune disease, comorbidities and immunosuppressive therapy,
including glucocorticoids (GCs), disease-modifying antirheumatic drugs (DMARDs):
conventional synthetic (csDMARDs), biological (bDMARDs) and targeted synthetic
DMARDs (tsDMARDs).
The current treatment concept is towards an intensive immunosuppressive therapy for
the purpose of achieving remission in most rheumatic diseases, these therapies are
usually used, in particular at early disease stages. It is key to move towards the
prevention of infections. This is crucial in the management of patients with AIIRD.
The use of vaccines is being used to prevent or inducing and/ or enhancing protective
immunity. Vaccine use is significantly important to patients with AIIRD, which leads to
lower rate of hospital admissions due to infections, emergency room visits and the rate
of invasive infectious diseases.
Most AIIRD sufferers usually don’t get enough vaccines partially due to a low rate of
referral for vaccination by rheumatologists and other doctors.
This is an indication that there is a need to get more awareness on the importance of
vaccinations especially among rheumatologists.
It is also important to ascertain the safety of the vaccines that are being used for people
with AIIRD.
There is a need to incorporate the new pieces of evidence on the incidence/prevalence
of vaccine preventable infections especially among AIIRD patients.
It is the goal of all healthcare professionals involved in the care for patients with AIIRD
to ensure infections are contained and the standards of treatment are constantly
updated.