POS1261 HERPES ZOSTER PREVENTION IN PATIENTS WITH AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASES: TAIWAN RHEUMATOLOGY ASSOCIATION (TRA) CONSENSUS

Le résumé fourni par la source

Background: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) have a higher incidence of herpes zoster (HZ) reactivation, shorter intervals between recurrences, and increased complications such as disseminated infection and post-herpetic neuralgia [1]. Although the live zoster vaccine (ZVL) is contraindicated for immunocompromised patients per its label, rheumatology societies have recommended it under specific conditions due to the significant burden of HZ [2]. The recent availability of the recombinant zoster vaccine (RZV) in many countries, including Taiwan, provides a potentially safer option for preventing HZ recurrence. Objectives: To develop evidence-based and expert consensus recommendations for preventing HZ in patients with AIIRD. Methods: A comprehensive literature review (January 2005–August 2024) examined HZ burden in AIIRD, the impact of immunosuppressive therapies, and the efficacy and safety of ZVL and RZV. An expert panel of 33 rheumatologists and 1 pediatric rheumatologist addressed key clinical questions and created nine voting statements, subsequently refined through an online Delphi process. Evidence quality and recommendation strength followed the GRADE system [3], while consensus levels were determined using the modified RAND/UCLA Appropriateness Method (median score >7) [4]. Results: The committee identified seven key clinical questions and developed nine consensus recommendations regarding herpes zoster vaccination in patients with AIIRD (Table 1 and Table 2 respectively). The recommendations prioritized high-risk groups within the AIIRD population, including those with specific autoimmune diseases and additional risk factors, such as age, use of JAK inhibitors and biologics, and prior HZ episode (recomendation 1-3). Although no direct head-to-head comparison between ZVL and RZV was available, the committee recommended RZV over ZVL based on vaccine type, safety considerations and labeling indication (recommendation 4). Timing of vaccination in relation to disease activity, immunosuppressants, and prior HZ episodes was discussed. However, limited high-quality evidence led to weak recommendations regarding the timing of vaccination (recommendation 5-9). Conclusion: Based on current evidence and expert opinions, recommendations for herpes zoster vaccination in patients with AIIRD were established. Further research is needed, particularly in evaluating the efficacy/effectiveness and safety of recombinant herpes zoster vaccination in patients with AIIRD. REFERENCES: [1] Furer V, et al. RMD Open. 2019 Sep 19;5(2):e001041; [2] Furer V et al. Ann Rheum Dis 2020;79:39–52. [3] Atkins D, et al. BMJ. 2004 Jun 19;328(7454):1490. [4] RAND/UCLA appropriateness method user's manual. Santa Monica, CA: RAND corporation; 2000. Table 1. Seven key clinical questions regarding herpes zoster prevention and summary of key evidence. Table 2. Nine consensus recommendations regarding herpes zoster prevention proposed by TRA-RMP group. Acknowledgements: We wound like to thank all members of TRA-RMP working group and Ms. Chih-Ying Tsai for their contribution to this consensus. Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.