[Secondary Immunodeficiency in Rheumatology].

Javet, Adrienn; Maurer, Britta (2022). [Secondary Immunodeficiency in Rheumatology]. Therapeutische Umschau, 79(6), pp. 289-294. Hogrefe 10.1024/0040-5930/a001363

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Secondary Immunodeficiency in Rheumatology Abstract. For the treatment of autoimmune and autoinflammatory diseases an immunosuppressive therapy with conventional, small molecule or biological disease modifying anti-rheumatic drugs (DMARDS) plays a key role. This may lead to secondary immunodeficiency with an increased risk for infections, which we discuss in the present article. The risk for reactivation of chronic hepatitis B increases particularly with glucocorticoid dosages of ≥ 20mg/d for longer than four weeks, with B-cell-depleting therapies, followed by anti-TNF-α-inhibitors. The latter also represent a risk for the reactivation of latent tuberculosis. High doses of glucocorticosteroids for prolonged periods increase the risk for pneumonia with Pneumocystis jirovecii, especially if combined with other DMARDs. An elevated risk for Herpes zoster exists for B-cell depletion, TNF-α-inhibition and for JAK blockade. Severe immunosuppression (B-cell depletion, cyclophosphamide, mycophenolate mofetil, JAK inhibitors, prednisone ≥ 20mg/d or combination therapy) increase the risk for severe COVID-19 infections.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology
UniBE Contributor:	Javet, Adrienn, Maurer, Britta
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0040-5930
Publisher:	Hogrefe
Language:	German
Submitter:	Pubmed Import
Date Deposited:	04 Aug 2022 13:32
Last Modified:	05 Dec 2022 16:22
Publisher DOI:	10.1024/0040-5930/a001363
PubMed ID:	35903826
URI:	https://boris.unibe.ch/id/eprint/171654