ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v18i5.2330ppharm-2066Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWЭффективность и безопасность вакцинации пациентов с ювенильным идиопатическим артритомEffectiveness and Safety of Vaccination in Patients with Juvenile Idiopathic Arthritishttps://orcid.org/0000-0002-2633-491XФридманИ. В.FridmanIrina V.

Фридман Ирина Владимировна

197022, Санкт-Петербург, ул. Профессора Попова, д. 9, тел.: +7 (812) 234-68-55; eLibrary SPIN: 9419-4368 

Irina V. Fridman

9 Professor Popov Str., 197022, St. Petersburg, +7 (812) 234-68-55; eLibrary SPIN: 9419-4368 

fridiv@mail.ruhttps://orcid.org/0000-0002-3187-8997ЛюбимоваН. А.LyubimovaNatalia A.

Любимова Наталья Андреевна

197341, Санкт-Петербург, ул. Аккуратова, д. 2, eLibrary SPIN: 2747-9319 

Natalia A. Lyubimova

2 Akkuratova Str., 197341, St. Petersburg, eLibrary SPIN: 2747-9319 

natali18111989@gmail.comhttps://orcid.org/0000-0002-1180-8086КостикМ. М.KostikMikhail M.

Костик Михаил Михайлович

197341, Санкт-Петербург, ул. Аккуратова, д. 2, eLibrary SPIN: 7257-0795 

Mikhail M. Kostik

2 Akkuratova Str., 197341, St. Petersburg, eLibrary SPIN: 7257-0795 

mikhail.kostik@gmail.comhttps://orcid.org/0000-0002-2371-2460ХаритС. М.KharitSusanna M.

Харит Сусанна Михайловна

197022, Санкт-Петербург, ул. Профессора Попова, д. 9, eLibrary SPIN: 1490-3699 

Susanna M. Kharit

9 Professor Popov Str., 197022, St. Petersburg, eLibrary SPIN: 1490-3699 

kharits@mail.ruhttps://orcid.org/0000-0002-0422-2060КонстантиноваЮ. Е.KonstantinovaYulia E.

Константинова Юлия Евгеньевна

197022, Санкт-Петербург, ул. Профессора Попова, д. 9, eLibrary SPIN: 6301-2354 

Yulia E. Konstantinova

9 Professor Popov Str., 197022, St. Petersburg, eLibrary SPIN: 6301-2354 

yulia.konstantinova23@mail.ruДетский научно-клинический центр инфекционных болезней ФМБА РоссииРоссияPediatric Research and Clinical Center for Infectious DiseasesRussian FederationНациональный медицинский исследовательский центр им. В.А. АлмазоваРоссияAlmazov National Medical Research CentreRussian FederationНациональный медицинский исследовательский центр им. В.А. Алмазова; Санкт-Петербургский государственный педиатрический медицинский университетРоссияAlmazov National Medical Research Centre; Federal State budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian FederationRussian FederationДетский научно-клинический центр инфекционных болезней ФМБА России; Санкт-Петербургский государственный педиатрический медицинский университетРоссияPediatric Research and Clinical Center for Infectious Diseases; Federal State budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian FederationRussian Federation202114112021185398407Copyright © Фридман И.В., Любимова Н.А., Костик М.М., Харит С.М., Константинова Ю.Е., 20212021Фридман И.В., Любимова Н.А., Костик М.М., Харит С.М., Константинова Ю.Е.Fridman I.V., Lyubimova N.A., Kostik M.M., Kharit S.M., Konstantinova Y.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/2066Обоснование

Обоснование. Вакцинация является наиболее эффективным средством снижения заболеваемости, инвалидизации, смертности от ряда инфекций. Однако долгое время существовало мнение, что для людей с ревматологическими заболеваниями, в том числе с ювенильным идиопатическим артритом (ЮИА), вакцины могут быть неэффективны и небезопасны.

Цель – проанализировать данные литературы о безопасности и эффективности вакцинации живыми и неживыми вакцинами пациентов с ЮИА.

Материалы и методы

Материалы и методы: анализ литературы по данным, представленным в медицинских базах данных PubMed и Google Scholar.

Результаты

Результаты. Как живые, так и неживые вакцины являются достаточно безопасными и иммуногенными для детей с ЮИА. Большинство исследований подтверждают эффективность вакцинации пациентов с ЮИА при применении глюкокортикостероидов (ГКС) и метотрексата, в тоже время терапия болезнь-модифицирующим антиревматическими препаратами (БМАРП) может ускорить снижение титров антител с течением времени. В целом длительность сохранности уровня антител у ранее привитых детей с ЮИА меньше, чем в популяции, что свидетельствует о необходимости введения им бустерных доз. Не выявлено негативного влияния на течение основного заболевания после вакцинации или развития поствакцинальных осложнений.

Выводы

Выводы. Вакцинация пациентов с ЮИА должна осуществляться с учетом терапии, которую получает пациент, под контролем уровня антител и при снижении титров ниже защитных – решением вопроса о введении бустерных доз.

Background

Background. Vaccination is the most effective method for reducing morbidity, disability, mortality from of various infections. However, there was a view for a long time that vaccines are ineffective and unsafe to use in people with rheumatological diseases, including juvenile idiopathic arthritis (JIA). Objective.

The aim of the study is to analyze literature data on safety and efficacy of vaccination for JIA patients with live and non-live vaccines.

Methods

Methods: literature analysis was based on data from medical databases PubMed and Google Scholar.

Results

Results. Both live and non-live vaccines are safe and immunogenic enough for children with JIA. Most studies confirm vaccination efficacy in patients with JIA when using glucocorticosteroids (GCS) and methotrexate, while therapy with disease-modifying antirheumatic drugs (DMARD) can reduce antibody titers over time. In general, antibodies levels preservation in previously vaccinated children with JIA is less than in global population. This indicates the need to administer booster doses for such patients. No adverse effects on the course of primary disease after vaccination and no post-vaccine complications were revealed.

Conclusion

Conclusion. Vaccination of patients with JIA should be performed with reference to the therapy that the patient already receives, under the control of antibodies level. Booster doses should be implemented in case of titers decrease below the protective levels.

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The authors declare that there are no conflicts of interest present.