SAT0570 GAPS IN PATIENT SAFETY PERFORMANCE IN PATIENTS WITH IMMUNOSUPPRESSIVE THERAPY: RESULTS OF SCREENING FOR INFECTIONS AND VACCINATION STATUS IN A LARGE REAL-LIFE COHORT

Abstract

Background Patients with chronic inflammatory rheumatic diseases (CIRD) are known to have an increased risk of infections compared to the general population. Therefore, prevention of infections by vaccination strategies is mandatory. Objectives To evaluate the vaccination status in patients with CIRD. Methods Consecutive patients with CIRD were prospectively recruited. Disease characteristics, vaccination status and screening for latent tuberculosis infection (LTBI) and hepatitis B (hepB) were analyzed. Antibodies against measles and hepB were measured. The vaccination status was assessed by a predefined vaccination score (range 0-26): 3 points for a complete vaccination, 2 points for a basic immunization and 1 point for an incomplete vaccination status for tetanus, diphtheria, poliomyelitis or pertussis. For hepB, pneumococcal, influenza, meningococcal, measles, rubella and varicella 2 points were given for a complete vaccination status and 1 point for an incomplete vaccination status. Finally, patients were categorized into 3 immunization states: low (0-6), moderate (7-13), good (14-20) and high (21-26). Results A total of 975 patients with CIRD were included (table 1). All patients on bDMARDs (n=499) were screened for LTBI, and 469 also for hepB (94%). Only 16 patients with LTBI received prophylaxis with isoniazid (3.2%) and only 16 patients with hepatitis B received prophylaxis with lamivudine (3.4%). The mean anti-HBs titer was 251.1±258.1 IU/l. Protective measles specific IgG-antibodies were found in 901 patients (92.4%). No more than 30% of patients had undergone pneumococcal vaccination and less than 20% were protected against hepB and influenza. Although 629 patients had been educated about vaccination strategies (64.5%), only 540 patients could show a vaccination certificate (55.4%). The mean vaccination score was 12.8±4.9 with 5.3% of patients categorized having a low, 24.3% a moderate, 26.1% a good and 1.8% a high score. Conclusion Screening for tuberculosis and hepatitis is successfully implemented in clinical routine in Germany but many patients are not sufficiently vaccinated against pneumococci, hepatitis B, influenza and measles. Our vaccination strategy is based on cooperation with GPs. However, this strategy did not seem to work. The overall rate of successful vaccination was low to moderate although patients received professional information about vaccine strategies. All values are given in mean (SD) otherwise indicated *Physical function was assessed with HQA except in axSpA patients in whom the BASFI was used. Disclosure of Interests: Uta Kiltz Grant/research support from: AbbVie, Chugai, Eli Lilly, Grunenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB., Consultant for: AbbVie, Chugai, Eli Lilly, Grunenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB., Aylin Celik: None declared, Styliani Tsiami: None declared, Bjorn Buhring Grant/research support from: GE/Lunar and Kinemed., Consultant for: GE/Lunar and Lilly, Xenofon Baraliakos Grant/research support from: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Centocor, Chugai, Janssen, MSD, Novartis, Pfizer Inc, Roche and UCB, Grant/research support from: AbbVie, Pfizer, Merck Sharp & Dohme, UCB Pharma, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Janssen Biologics, Novartis, Pfizer, UCB Pharma, Galapagos, Speakers bureau: AbbVie, Chugai, Janssen, Novartis, Pfizer, UCB Pharma, Juergen Braun Shareholder of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Consultant for: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson & Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Speakers bureau: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB