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Topics:
Rheumatology
•
Infectious Disease
Is there any evidence that TNF inhibitors alter immunogenicity of vaccines?
If so, does delaying/skipping a dose improve immunogenicity?
Related Questions
In a patient with negative Hep B surface Ag, Hep B surface antibody+, and Hep B core antibody+ serologies, do you initiate antiviral prophylaxis (e.g. entecavir) prior to starting rituximab?
Is it ever safe to use a biologic DMARD in a patient with RA who is on suppressive antibiotics due to a history of septic prosthetic arthritis?
How do you approach vaccination, particularly the use of live vaccines such as yellow fever, in a patient with rheumatoid arthritis receiving a TNF inhibitor who is planning travel to Africa?
Can inflammatory arthritis develop in patients with a history of chronic hepatitis B?
How would you treat an asymptomatic patient with a positive Blastomyces antibody, evidence of prior granulomatous lung disease on imaging, and who may require immunosuppression in the future?
What is the recommended fungal workup in an immunocompromised patient after 5 days of persistent fever?
In light of recent measles outbreaks, have you adjusted your vaccination counseling or preventive strategies for adult immunocompromised patients?
What is the interpretation of an IGRA with positive TB wells and negative nil and negative mitogen wells?
In a patient with a history of seropositive erosive RA who has undergone treatment for a periprosthetic joint infection and currently has an antibiotic spacer in place with clinical improvement, what is the appropriate timing and strategy for restarting DMARDs and/or biologic therapy to balance infection risk with RA disease control?
What are your vaccine recommendations while patients are on biologics?