背景:对于需要接受非活疫苗或活疫苗的银屑病患者,对于是否暂停或继续进行银屑病和/或银屑病关节炎的全身治疗,我们需要提供循证建议.
目的:评估有关疫苗效力和安全性的文献,并为接受非活疫苗或活疫苗的银屑病和/或银屑病关节炎全身治疗的成人提供基于共识的建议。
方法:使用修改后的Delphi过程,国家银屑病基金会医学委员会和COVID-19工作组制定了22项共识声明,和传染病专家。
结果:主要建议包括对接受非活疫苗的患者继续进行大多数口服和生物治疗而不进行修改;考虑对非活疫苗停止甲氨蝶呤治疗。对于接受活疫苗的患者,在活疫苗给药之前和之后停止大多数口服和生物药物治疗.具体建议包括停止大多数生物疗法,除了Abatacept,活疫苗给药前2-3个半衰期,并在活疫苗接种后2-4周推迟下一剂量。
结论:缺乏关于疫苗接种后感染率的研究。
结论:接受非活疫苗的患者通常不需要中断抗银屑病口服和生物治疗。在大多数情况下,建议在施用活疫苗之前和之后暂时中断口服和生物治疗。
BACKGROUND: For psoriatic patients who need to receive nonlive or live vaccines, evidence-based recommendations are needed regarding whether to pause or continue systemic therapies for psoriasis and/or psoriatic arthritis.
OBJECTIVE: To evaluate literature regarding vaccine efficacy and safety and to generate
consensus-based recommendations for adults receiving systemic therapies for psoriasis and/or psoriatic arthritis receiving nonlive or live vaccines.
METHODS: Using a modified Delphi process, 22
consensus statements were developed by the National Psoriasis Foundation Medical Board and COVID-19 Task Force, and infectious disease experts.
RESULTS: Key recommendations include continuing most oral and biologic therapies without modification for patients receiving nonlive vaccines; consider interruption of methotrexate for nonlive vaccines. For patients receiving live vaccines, discontinue most oral and biologic medications before and after administration of live vaccine. Specific recommendations include discontinuing most biologic therapies, except for abatacept, for 2-3 half-lives before live vaccine administration and deferring next dose 2-4 weeks after live vaccination.
CONCLUSIONS: Studies regarding infection rates after vaccination are lacking.
CONCLUSIONS: Interruption of antipsoriatic oral and biologic therapies is generally not necessary for patients receiving nonlive vaccines. Temporary interruption of oral and biologic therapies before and after administration of live vaccines is recommended in most cases.