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Recommendations for infectious disease screening in migrants to Western Europe with inflammatory arthropathies before starting biologic agents. Results from a multidisciplinary task force of four European societies (SIR, SER, SIMET, SEMTSI) facing the lar

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

  1. SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy.
  2. Rheumatology Unit, Department of Medical Sciences, University of Ferrara, and Epidemiology Unit, Italian Society for Rheumatology, Milano, Italy.
  3. Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clínic, Universitat de Barcelona, Spain.
  4. Division of Rheumatology, Hospital Virgen del Puerto, Plasencia, Spain.
  5. Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy.
  6. Division of Rheumatology, University of Pavia, IRCCS S. Matteo Foundation, Pavia, Italy.
  7. Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University, Rome, Italy.
  8. Department of Medicine, Universidad de La Laguna, Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain.
  9. Servicio de Reumatologia, Hospital Universitario de Mostoles, Madrid, Spain.
  10. Research Unit, Spanish Society of Rheumatology, Madrid, Spain.
  11. Infectious Diseases Unit, University Hospital of Trieste, Italy.
  12. Division of Rheumatology, San Camillo Hospital, Rome, Italy.
  13. Division of Rheumatology, San Camillo Hospital, Rome, Italy.
  14. General Directorate, San Camillo Hospital, Rome, Italy.
  15. Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clínic, Universitat de Barcelona, Spain.
  16. Division of Rheumatology, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Spain.
  17. Division of Rheumatology, University of Pavia, IRCCS S. Matteo Foundation, Pavia, Italy.
  18. Division of Rheumatology, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Spain.
  19. SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy.
  20. University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Italy.
  21. SOD Malattie Infettive e Tropicali, Careggi Hospital, Florence, Italy.
  22. Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy.
  23. Unidad de Vacunación Internacional, Instituto Hispalense de Pediatría, Granada; and Spanish Society of Tropical Medicine and International Health, Spain.
  24. Division of Rheumatology, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Spain.
  25. Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, Italy. marco.matuccicerinic@unifi.it

CER10093 Submission on line
2017 Vol.35, N°5 - PI 0752, PF 0765
Full Papers

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Rheumatology Article

 

Abstract

OBJECTIVES:
Inflammatory arthritis needs infectious disease screening before starting a biologic agent, however, few data are known about migrant patients, who represent a peculiar population which requires a multidisciplinary approach among international health specialists and should also be considered by health authorities. For this reason, the Italian and Spanish Societies of Rheumatology (SIR and SER) and Tropical Medicine (SIMET and SEMTSI) promoted a multidisciplinary task force in order to produce specific recommendations about screening and advices to be considered in migrant patients with inflammatory arthritis candidate to receive biological therapy, according to their geographical origin.
METHODS:
The experts provided a prioritised list of research questions and the eligible spectrum of inflammatory arthritis, biologic drugs and infectious disease were defined in order to perform a systematic literature review. A search was made in Medline, Embase and Cochrane library, updated to March 2015. Ubiquitous infections and HBV, HCV, HIV and tuberculosis that are already considered in national and international recommendations, were not included. The strength of each recommendation was determined.
RESULTS:
The task force members agreed on 7 overarching principles. The risk of reactivation of selected potentially latent infectious disease was addressed in migrants with inflammatory arthritis candidates for biologics was considered and 15 potentially relevant infections were identified.
CONCLUSIONS:
Fifteen disease-specific recommendations were formulated on the basis of high level of agreement among the experts panel.

PMID: 28516869 [PubMed]

Received: 10/11/2016 - Accepted : 23/01/2017 - In Press: 08/05/2017 - Published: 15/09/2017