巴瑞替尼片治疗期间是否可以接种带状疱疹疫苗? |
本文旨在提供关于巴瑞替尼片治疗期间接种带状疱疹疫苗的相关信息,仅供医疗卫生专业人士参考。 |
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巴瑞替尼与带状疱疹相关的安全性特征
巴瑞替尼(BARI)临床研究中报告了病毒再激活,包括疱疹病毒再激活的发生。如果患者发生了带状疱疹(HZ)感染,则应该暂时停止 BARI 治疗,直至症状痊愈。1
带状疱疹疫苗接种
没有正在接受巴瑞替尼治疗的患者对活疫苗的应答数据。不推荐将巴瑞替尼与活疫苗一起使用。在开始巴瑞替尼治疗前,建议按照现行免疫接种指南接种近期需要接种的所有疫苗。1
由于不同区域有关疫苗接种的建议可能有所不同,自身免疫疾病患者接种疫苗(包括 HZ 减毒活疫苗和非活 HZ 疫苗) 请遵循当地疫苗接种相关指南及当地说明书 。
带状疱疹活疫苗和其他 JAK 抑制剂的经验有限
关于 Janus 激酶(JAK)抑制剂托法替布与 HZ 活疫苗一起使用的信息已发表,参考文献部分提供了索引。2-4
类风湿关节炎患者带状疱疹疫苗接种指南
对于 HZ 的预防,美国免疫实践咨询委员会(ACIP)建议 50 岁或以上的患者使用非活 HZ 疫苗,包括患有慢性疾病(如 RA)的患者。5
ACIP 尚未就接受中等或高剂量免疫抑制治疗的患者使用非活 HZ 疫苗提出建议,因为缺乏在该患者群体中的数据。5
美国疾病预防控制中心建议 50 岁及以上患有慢性疾病(如 RA)的免疫功能正常的成年人接种非活 HZ 疫苗。非活 HZ 疫苗可用于以下成年人
- 接受低剂量免疫抑制治疗,或
- 预期免疫抑制。6
参考文献
1Data on file, Eli Lilly and Company and/or one of its subsidiaries.
2Winthrop KL. The emerging safety profile of JAK inhibitors in rheumatic disease. Nat Rev Rheumatol. 2017;13(4):234-243. http://www.nature.com/nrrheum/journal/v13/n4/full/nrrheum.2017.23.html? foxtrotcallback=true
3Winthrop KL, Wouters AG, Choy EH, et al. The safety and immunogenicity of live zoster vaccination in patients with rheumatoid arthritis before starting tofacitinib: a randomized phase II trial. Arthritis Rheumatol. 2017;69(10):1969-1977. https://doi.org/10.1002/art.40187
4Calabrese LH, Abud-Mendoza C, Lindsey S, et al. Evaluation of live zoster vaccine in a subset of patients with rheumatoid arthritis treated with tofacitinib with or without methotrexate, and adalimumab with methotrexate: results from a phase 3b/4 randomized trial. Arthritis Rheumatol. 2017;69(suppl 10). American College of Rheumatology abstract 2393. http://acrabstracts.org/abstract/evaluation-of-live-zoster-vaccine-in-a-subset-of-patients-with-rheumatoid-arthritis-treated-with-tofacitinib-with-or-without-methotrexate-and-adalimumab-with-methotrexate-results-from-a-phase-3b4-r/
5Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep. 2018;67(3):103-108. http://dx.doi.org/10.15585/mmwr.mm6703a5
6Shingrix recommendations. Centers for Disease Control and Prevention. Updated October 5, 2020. Accessed December 14, 2021. https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/recommendations.html
7Cush JJ. Prevention and management of serious infections with biologic use in rheumatoid arthritis. Drug Safety Quarterly. 2013;(4)4:1-3. http://www.rheumatology.org/Portals/0/Files/DSQ%20Winter%202013.pdf
8Zhang J, Xie F, Delzell E, et al. Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases. JAMA. 2012;308(1):43-49. http://dx.doi.org/10.1001%2Fjama.2012.7304
9Lindsey S, Oufnac B, Walker H. Safety of zoster vaccination administration in rheumatic patients on current biologic therapy. Arthritis Rheumatol. 2014;66(suppl 10):S806. American College of Rheumatology abstract 1836. http://acrabstracts.org/abstract/safety-of-zoster-vaccination-administration-in-rheumatic-patients-on-current-biologic-therapy/