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Lakhmiri R, Cherrah Y, Serragui S. Tumor Necrosis Alpha (TNF-α) Antagonists Used in Chronic Inflammatory Rheumatic Diseases: Risks and their Minimization Measures. Curr Drug Saf 2024; 19:431-443. [PMID: 38204274 DOI: 10.2174/0115748863274863231222023853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 01/12/2024]
Abstract
Tumor necrosis factor alpha (TNF- α) inhibitors are widely employed for the management of chronic inflammatory rheumatism. However, their usage carries significant risks, including site and infusion reactions, serious infections, malignancy, heart failure autoimmune and demyelinating disorders. These risks are comprehensively outlined in risk management plans (RMPs) associated with these molecules. RMP provides information on the safety profile of a medicinal product as well as the measures that will be taken to minimize risks; these are known as risk minimization measures. These measures are divided into routine measures related to elements, such as the summary of product characteristics, labeling, pack size, package leaflet, or legal supply status of the product, while additional measures may include educational programs, including tools for healthcare providers and patients, controlled access or pregnancy prevention programs, among others. Additional measures can consist of one or more interventions that need to be implemented in a sustainable way in a defined target group, while respecting the timing and frequency of any intervention and procedures to reach the target population. An evaluation of the effectiveness of these measures is required to determine whether or not an intervention has been effective. This comprehensive review offers an in-depth exploration of the current treatment, uses, and associated risks of TNF-α inhibitors. Additionally, it provides a detailed account of risk minimization measures and risk management practices while shedding light on their real-world implementation and effectiveness.
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Affiliation(s)
- Rim Lakhmiri
- Pharmaco-Epidemiology and Pharmaco-Economics Research Team - Laboratory of Pharmacology and Toxicology - Faculty of Medicine and Pharmacy -Mohammed V University of Rabat, Morocco
| | - Yahia Cherrah
- Pharmaco-Epidemiology and Pharmaco-Economics Research Team - Laboratory of Pharmacology and Toxicology - Faculty of Medicine and Pharmacy -Mohammed V University of Rabat, Morocco
| | - Samira Serragui
- Pharmaco-Epidemiology and Pharmaco-Economics Research Team - Laboratory of Pharmacology and Toxicology - Faculty of Medicine and Pharmacy -Mohammed V University of Rabat, Morocco
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COVID-19 Vaccination in Pediatrics: Was It Valuable and Successful? Vaccines (Basel) 2023; 11:vaccines11020214. [PMID: 36851090 PMCID: PMC9964251 DOI: 10.3390/vaccines11020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The mass vaccination of children against coronavirus 2019 disease (COVID-19) has been frequently debated. The risk-benefit assessment of COVID-19 vaccination versus infection in children has also been debated. AIM This systematic review looked for answers to the question "was the vaccination of our children valuable and successful?". METHODS The search strategy of different articles in the literature was based on medical subject headings. Screening and selection were based on inclusion/exclusion criteria. RESULTS AND DISCUSSION The search results revealed that the majority of the reported adverse events after COVID-19 vaccination in pediatrics were mild to moderate, with few being severe. Injection site discomfort, fever, headache, cough, lethargy, and muscular aches and pains were the most prevalent side effects. Few clinical studies recorded significant side effects, although the majority of these adverse events had nothing to do with vaccination. In terms of efficacy, COVID-19 disease protection was achieved in 90-95% of cases for mRNA vaccines, in 50-80% of cases for inactivated vaccines, and in 58-92% of cases for adenoviral-based vaccines in children and adolescents. CONCLUSIONS Based on available data, COVID-19 immunizations appear to be safe for children and adolescents. Furthermore, multiple studies have proven that different types of vaccines can provide excellent protection against COVID-19 in pediatric populations. The efficacy of vaccines against new SARS-CoV-2 variants and the reduction in vaccine-related long-term adverse events are crucial for risk-benefit and cost-effectiveness assessments; therefore, additional safety studies are required to confirm the long-term safety and effectiveness of vaccinations in children.
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Koç Yıldırım S, Demirel Öğüt N, Erbağcı E. Retrospective evaluation of patients with chronic spontaneous urticaria using omalizumab during the COVID-19 pandemic. J Cosmet Dermatol 2022; 21:431-434. [PMID: 34982508 DOI: 10.1111/jocd.14725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Omalizumab (OMZ) is a monoclonal anti-immunoglobulin E antibody used in patients with chronic spontaneous urticaria (CSU). The data about using OMZ during the coronavirus disease 19 (COVID-19) pandemic are limited. The aim of this study was to evaluate the status of having COVID-19 and relationships between COVID-19, vaccination, and urticaria symptoms of CSU patients on OMZ. METHOD We conducted a retrospective cohort study of 36 adult CSU patients treated with OMZ. Demographic data, the results of COVID-19 real-time polymerase chain reaction (RT-PCR), and vaccination status were recorded from the electronic medical records. RESULTS Thirty-six patients, 23 women, and 13 men were evaluated. The mean age was 45.81 years. Two patients were diagnosed with COVID-19 while using OMZ. Four patients interrupted their OMZ treatment during the pandemic, and OMZ treatments were restarted in all patients. There were 28 patients who had at least one dose of vaccine (inactive and/or mRNA vaccine). Only one patient had an urticaria exacerbation after the first dose of mRNA vaccine. CONCLUSION As a result, our findings have shown that omalizumab treatment in CSU patients during the COVID-19 pandemic does not increase the risk of COVID-19 infection and omalizumab can be used safely.
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Affiliation(s)
- Sema Koç Yıldırım
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Ece Erbağcı
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
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Ramirez GA, Asperti C, Cucca V, Yacoub MR. Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases. Vaccines (Basel) 2021; 9:1147. [PMID: 34696255 PMCID: PMC8537812 DOI: 10.3390/vaccines9101147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 12/22/2022] Open
Abstract
Aberrant deployment of the immune response is a hallmark pathogenic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19), possibly accounting for high morbidity and mortality, especially in patients with comorbidities, including immune-mediated disorders. Immunisation with SARS-COV-2 vaccines successfully instructs the immune system to limit viral spread into tissues, mitigate COVID-19 manifestations and prevent its most detrimental inflammatory complications in the general population. Patients with immune-mediated diseases have been excluded from vaccine registration trials, foreclosing the acquisition of specific efficacy and safety data. In this review, we aimed to summarise and critically discuss evidence from real-world studies addressing this issue to provide a comprehensive view of the impact of vaccination practices in patients with allergy, autoimmunity or immunodeficiency. We analysed clinical and laboratory data from 34 studies involving more than 13,000 subjects with various immune disorders who were vaccinated with mRNA- DNA- or inactivated viral particle-based vaccines. These data globally support the safe and effective use of SARS-CoV-2 vaccines in patients with immune-mediated diseases, although patient-tailored strategies to determine vaccination timing, vaccine choice and background therapy management are warranted to optimise vaccination outcomes. More data are needed regarding patients with primary immunodeficiencies.
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Affiliation(s)
- Giuseppe A. Ramirez
- Division of Immunology, Transplants and Infectious Diseases, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (C.A.); (V.C.); (M.-R.Y.)
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Chiara Asperti
- Division of Immunology, Transplants and Infectious Diseases, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (C.A.); (V.C.); (M.-R.Y.)
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Valentina Cucca
- Division of Immunology, Transplants and Infectious Diseases, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (C.A.); (V.C.); (M.-R.Y.)
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Mona-Rita Yacoub
- Division of Immunology, Transplants and Infectious Diseases, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (C.A.); (V.C.); (M.-R.Y.)
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
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Simonetti O, Radi G, Molinelli E, Rizzetto G, Diotallevi F, Offidani A. Recommendations for dermatologists treating patients with atopic dermatitis during the Covid-19 pandemic: a look into the past for a conscious vaccination management. Hum Vaccin Immunother 2021; 17:3268-3275. [PMID: 34170791 PMCID: PMC8437527 DOI: 10.1080/21645515.2021.1925502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects approximately 20% of children and 10% of adults. The implication of vaccines as a trigger for the de novo onset of AD in children or as a cause of exacerbation in individuals with a history of AD has long been debated. We present a brief review of the literature on AD and traditional vaccinations, proposing in addition the main recommendations for the management of patients with AD undergoing the vaccine against the SARS-COV-2 virus. Live attenuated vaccines seem to be associated with a relapse of AD and/or complications, such as eczema vaccinatum. For non-live vaccines, no adverse events are noted in atopic subjects. Since the Covid-19 vaccine is mRNA or viral vectored vaccine and there are no other currently used vaccines of this type, the same recommendations are applied as for all other non-live vaccines.
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Affiliation(s)
- Oriana Simonetti
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Giulia Radi
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Elisa Molinelli
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Federico Diotallevi
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Clinic Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
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Zheng YJ, Wang XC, Feng LZ, Xie ZD, Jiang Y, Lu G, Li XW, Jiang RM, Deng JK, Liu M, Xu BP, Wei Z, Liu G, Lu XX, Jin RM, Liu ZS, Shang YX, Shu SN, Bai Y, Lu M, Liu GH, Luo WJ, Cui YX, Ye LP, Lin LK, Zhao DC, Shen AD, Shao JB, Xiong LJ, Gao LW, Wang TY, Zhao ZY, Yang YH, Shen KL. Expert consensus on COVID-19 vaccination in children. World J Pediatr 2021; 17:449-457. [PMID: 34618327 PMCID: PMC8494629 DOI: 10.1007/s12519-021-00465-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Yue-Jie Zheng
- Department of Respiratory Disease, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiao-Chuan Wang
- Department of Allergy and Clinical Immunology, Children's Hospital of Fudan University, Shanghai, China
| | - Lu-Zhao Feng
- School of Population Medicine and Public Health, Peking Union Medical College, Beijing, China
| | - Zheng-De Xie
- Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yi Jiang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Gen Lu
- Department of Respiratory Disease, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Xing-Wang Li
- Diagnosis and Treatment Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Rong-Meng Jiang
- Diagnosis and Treatment Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Miao Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Bao-Ping Xu
- Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Zhuang Wei
- Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Gang Liu
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiao-Xia Lu
- Department of Respiratory Disease, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Run-Ming Jin
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Sheng Liu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Xiao Shang
- Department of Pediatric Respiratory Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Sai-Nan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Bai
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Lu
- Department of Respiratory Disease, Children's Hospital of Shanghai, Shanghai, China
| | - Guang-Hua Liu
- Department of Pediatrics, Fujian Branch of Shanghai Children's Medical Center, Fujian Children's Hospital, Fuzhou, China
| | - Wan-Jun Luo
- Office of Healthcare-Associated Infection Management, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Xia Cui
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang, China
| | - Le-Ping Ye
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Li-Kai Lin
- Hospital Management Institute of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Dong-Chi Zhao
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - A-Dong Shen
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Jian-Bo Shao
- Department of Radiology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li-Juan Xiong
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li-Wei Gao
- Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China
| | - Tian-You Wang
- Hematology and Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zheng-Yan Zhao
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Yong-Hong Yang
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.
| | - Kun-Ling Shen
- Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.
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Niebel D, Novak N, Wilhelmi J, Ziob J, Wilsmann-Theis D, Bieber T, Wenzel J, Braegelmann C. Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective. Vaccines (Basel) 2021; 9:944. [PMID: 34579181 PMCID: PMC8470727 DOI: 10.3390/vaccines9090944] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.
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Affiliation(s)
- Dennis Niebel
- Department of Dermatology and Allergy, University Hospital Bonn, 53127 Bonn, Germany; (N.N.); (J.W.); (J.Z.); (D.W.-T.); (T.B.); (J.W.); (C.B.)
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