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    Home > Active Ingredient News > Immunology News > ACR's latest guidelines: should rheumatism patients get the new crown vaccine?

    ACR's latest guidelines: should rheumatism patients get the new crown vaccine?

    • Last Update: 2021-04-19
    • Source: Internet
    • Author: User
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    *Only for medical professionals to read for reference! Given that China's new coronavirus pneumonia (COVID-19) vaccine is relatively sufficient and free of charge, the current vaccination rate is still low.

    The survey shows that although most people have the willingness to receive the COVID-19 vaccine, there are also some people who have concerns about the safety of the vaccine, have low willingness to vaccinate, and are on the sidelines.

    In particular, whether patients with rheumatic immune diseases can be vaccinated has attracted extensive attention from medical professionals and the patients themselves.

     In March 2021, the American College of Rheumatology (ACR) issued guidelines for vaccination against COVID-19 for patients with rheumatism and musculoskeletal diseases (RMD), aiming to better provide vaccination advice for patients with rheumatism and promote vaccines for RMD patients Implementation of vaccination.

    The following editor summarizes the general precautions, recommendations, and the use and time of immunomodulatory drugs in the guide for RMD vaccination.
    Let's take a look! How to fight the 3 superficial fresh crown vaccines! First of all, the ACR guidelines point out that compared with the general population, patients with autoimmune and inflammatory rheumatic diseases (AIIRD) have a higher risk of viral infection, a higher risk of hospitalization, and a worse prognosis.

    Therefore, in addition to being allergic to vaccine components, patients with AIIRD should be given priority in vaccination (Table 1).

    Table 1: General precautions for COVID-19 vaccination for patients with RMDs.
    Note: RMD = rheumatic and musculoskeletal diseases; AIIRD = autoimmune and inflammatory rheumatic diseases.
    Many patients are worried about whether the disease is active, can they get the vaccine? The guidelines suggest that as long as they are not life-threatening, AIIRD patients should be vaccinated! Which vaccine is better? The guide clearly states that the current vaccine data shows that no COVID-19 vaccine is better than the other.
    Therefore, which vaccine is available for AIRRD patients! Table 2 Recommendations for the use of COVID-19 vaccine for RMD patients.
    Note: EUA = emergency use authorization; FDA = US Food and Drug Administration; mRNA = messenger RNA; CDC = Center for Disease Control; ICU = intensive care unit.

    *As of January 2021, ≥16 years of age, many patients have questions again, "Now I take immunosuppressants and hormones, how do I stop the drugs before and after the vaccine?" This guide classifies the drugs, and patients can check the following table by themselves Clarify how to use immunosuppressants.

    Table 3: Guidelines for immunomodulatory treatment drugs and timing related to COVID-19 vaccination for RMD patients *Note: *The guidance for "pause" treatment is based on the assumption that the patient's disease control is adequate and temporary interruption is allowed; if not, it should be based on the involved The specific situation determines the decision.

    IL-6R = sarilumab; tocilizumab; IL-1R = anakinra, canakinumab; IL-17 = ixekizumab, secukinumab; IL-12/23 = ustekinumab; IL-23 = guselkumab, rizankizumab; JAKi = baricitinib, tofacitinib, upadacitinib In summary, the ACR guidelines include the best use of the COVID-19 vaccine for patients with rheumatic and musculoskeletal diseases.

    The general principle is that due to lack of information about COVID-19 vaccination in RMD patients and lack of direct evidence, it is necessary to make inferences based on other published vaccine literature.

    Therefore, the quality of the evidence is low, and it is indirectly affected in almost all aspects.

    Although there is a lack of direct evidence, this guideline aims to provide guidance for rheumatism healthcare providers on how to best use the COVID-19 vaccine and promote the implementation of vaccination strategies for RMD patients.

    References: [1] Curtis JR, Johnson SR, Anthony DD.
    et al.
    American College of Rheumatology Guidance for COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases-Version 1.
    Arthritis Rheumatol, 2021, Mar 17.
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