Live Attenuated Vaccine Administration in Children Treated With Methotrexate or Dupilumab.

IF 1.2 4区医学 Q3 DERMATOLOGY

Pediatric Dermatology Pub Date : 2024-12-11 DOI:10.1111/pde.15818

Julia R Hughes, Sino Mehrmal, Sana Habib, Howard L Williams, Elaine C Siegfried

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引用次数: 0

Abstract

Background and objectives: A wholesale recommendation against use of live virus vaccines in patients treated with any medication classified as an immunosuppressant has been based on global theoretical concerns rather than clinical outcomes for specific drugs.

Methods: A retrospective search of electronic medical records identified patients seen by the Allergy and/or Dermatology services between 2017 and 2023 at a pediatric tertiary center who received a live attenuated vaccine during the 6 week interval prior to the first prescription for methotrexate or dupilumab until 6 weeks after the last prescription for either medication. Individual charts of identified patients were manually reviewed for evidence of adverse events.

Results: The search identified 313 pediatric patients treated with dupilumab and/or methotrexate during the 7-year interval. Five of these patients received the combination measles, mumps, rubella, and varicella (MMRV) vaccine while on dupilumab and 4 while on methotrexate. Manual chart review was without evidence of adverse events for up to 6 months after immunization.

Conclusions: This retrospective search identified a small number of pediatric patients immunized with the live attenuated MMRV vaccine during concomitant treatment with dupilumab or methotrexate. No associated adverse events were identified. Further investigation is needed to establish the safety and efficacy of live vaccines in patients treated with these immunomodulating agents.

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甲氨蝶呤或杜匹单抗治疗儿童减毒活疫苗的应用

背景和目的：在接受任何免疫抑制剂药物治疗的患者中，反对使用活病毒疫苗的大规模建议是基于全球理论问题，而不是基于特定药物的临床结果。方法：对电子医疗记录进行回顾性检索，确定了2017年至2023年在儿科三级中心过敏和/或皮肤科服务部门就诊的患者，这些患者在首次处方甲氨蝶呤或杜比单抗之前的6周间隔内接受了减毒活疫苗，直到最后一次处方这两种药物后的6周。对已确定患者的个别图表进行人工审查，以寻找不良事件的证据。结果：在7年的时间间隔内，研究确定了313名接受dupilumab和/或甲氨蝶呤治疗的儿科患者。这些患者中有5人接受了麻疹、腮腺炎、风疹和水痘（MMRV）联合疫苗，同时接受了杜匹单抗治疗，4人接受了甲氨蝶呤治疗。手工图表审查没有证据表明免疫接种后6个月内出现不良事件。结论：本回顾性研究发现，在dupilumab或甲氨蝶呤联合治疗期间，有少数儿童患者接种了MMRV减毒活疫苗。未发现相关不良事件。需要进一步调查以确定活疫苗在接受这些免疫调节剂治疗的患者中的安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Dermatology 医学-皮肤病学

CiteScore

3.20

自引率

6.70%

发文量

269

审稿时长

1 months

期刊介绍： Pediatric Dermatology answers the need for new ideas and strategies for today''s pediatrician or dermatologist. As a teaching vehicle, the Journal is still unsurpassed and it will continue to present the latest on topics such as hemangiomas, atopic dermatitis, rare and unusual presentations of childhood diseases, neonatal medicine, and therapeutic advances. As important progress is made in any area involving infants and children, Pediatric Dermatology is there to publish the findings.