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3PC-020 Prevention of infectious risk in patients treated with tumour necrosis factor alpha inhibitors (anti-TNFα)
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  1. ZRibera Ruiz De Vergara1,
  2. AI Idoate Grijalba1,
  3. L Cabia Fernández1,
  4. M De Miguel Gaztelu2
  1. 1Hospital García Orcoyen, Pharmacy Service, Estella- Navarra, Spain
  2. 2Central Services, Primary Care Pharmacy, Pamplona- Navarra, Spain

Abstract

Background and Importance Tumour necrosis factor alpha inhibitors (anti-TNFα) have become a common treatment in many diseases, but they can increase susceptibility to infectious diseases, including tuberculosis.

Aim and Objectives Evaluate the analysis record and vaccination schedules in patients with anti-TNFα treatment in our hospital.

Material and Methods We have reviewed clinic history of all outpatients of the Pharmacy Service in a regional hospital who are currently administering subcutaneous anti-TNF (adalimumab, certolizumab, golimumab and etanercept). The informatics programs Farho and HCl are used to review if tuberculin test or Quantiferon assay, recommended vaccination schedule by the Prevention Service of the hospital and hepatitis serology have been requested (hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis A (HAV)).

Results 147 patients with anti-TNFα have been analysed, with a mean age of 49 years (14–84), of which 53% (n=78) are men. 18.37% (n=27) had rheumatoid arthritis, 15.65% (n=23) psoriasis, 14.97% (n=22) psoriatic arthritis, 10.20% (n=15) ankylosing spondylitis, 19.05% (n=28) other spondyloarthropathies, 1.36% (n=2) juvenile idiopathic arthritis, 17.01% (n=25) inflammatory bowel disease, and 3.40% (n=5) others. Tuberculin/quantiferon testing was completed in 87.07% of patients; 12.50% of them were positive and received isoniazid for 9 months. Serological markers have been recorded in 93.20% and 91.16% of patients for HBV and HCV respectively, all of which were negative. 41.50% of the patients received four doses of HBV vaccine, because they presented anti-HBs <10 mUl/ml. 10.88% of the total patients received two doses of the HAV vaccine with an interval of 6 months. 81.63% of patients were vaccinated with the pneumococcal vaccine. 51.02% of patients have received the flu vaccine annually.

Conclusion and Relevance Regarding the safety guidelines, the recommended screening and vaccination schedules are completed and recorded in the majority of patients (>85% patients). Nevertheless, it would be necessary to reconcile the way of registering data in order to simplify the recording of tests performed and the monitoring of administered vaccines.

Conflict of Interest No conflict of interest.

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