Saturday, September 30, 2023

Flu Shot And Psoriatic Arthritis

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The Importance Of Getting Your Vaccinations

Vaccinations for the Arthritis Patient

Do you wonder if vaccines are dangerous? Have you read articles that raised concern about the safety of vaccines for people with chronic conditions? Has someone told you that the flu vaccine can cause you to get the flu?

At Rheumatology Solutions, our staff of experts would like to take a moment to discuss why vaccines are especially important for people who have chronic conditions, especially conditions that fall under the umbrella of rheumatic disease. Whether you have psoriatic arthritis, systemic lupus, gout, or any other rheumatic condition, vaccinations could save your life.

In this post, we present some commonly held misconceptions about vaccinations, as well as some reasons getting vaccinated is critically important for people with chronic health conditions.

Before Taking This Medicine

You should not use Simponi if you are allergic to golimumab.

To make sure Simponi is safe for you, tell your doctor if you have ever had:

  • active or chronic infections

  • psoriasis or

  • if you are scheduled to receive any vaccine.

Tell your doctor if you have ever had tuberculosis or if anyone in your household has tuberculosis. Also tell your doctor if you have recently traveled. Tuberculosis and some fungal infections are more common in certain parts of the world, and you may have been exposed during travel.

Using Simponi may increase your risk of developing autoimmune disorders or cancer, including skin cancer. Talk to your doctor about this risk and what symptoms to watch for.

Simponi may cause a rare type of lymphoma of the liver, spleen, and bone marrow that can be fatal. This has occurred mainly in teenagers and young men with Crohn’s disease or ulcerative colitis. Anyone with an inflammatory autoimmune disorder may have a higher risk of lymphoma. Talk with your doctor about your own risk.

Tell your doctor if you are pregnant or plan to become pregnant. Your baby could have an increased risk of infection for up to 6 months if you use Simponi during pregnancy.

If you use Simponi during pregnancy, your newborn baby should not receive a live vaccine for at least 6 months after you last received a dose of this medicine.

You should not breastfeed while using this medicine.

Digestive Disorders And Psoriatic Arthritis

Did you know having psoriatic arthritis might also affect your gut?

A study published in November 2016 in Clinical Rheumatology found people with psoriatic arthritis are at risk for having the following conditions:

  • Crohns disease, a chronic inflammatory bowel disease that affects the lining of the digestive tract
  • Ulcerative colitis, a chronic inflammatory bowel disease that causes inflammation in the digestive tract
  • Reflux esophagitis, a condition where inflammation damages the esophagus
  • Peptic ulcer disease, a condition that causes painful sores or ulcers in the lining of the stomach or small intestine

Another study, published in December 2018 in JAMA Dermatology, revealed people with psoriasis were around 2 times more likely to develop Crohns and ulcerative colitis compared with the general population.

The authors concluded: These findings suggest that psoriasis is significantly associated with IBD. Gastroenterology consultation may be indicated when patients with psoriasis present with bowel symptoms.

Scientists believe that the same gene mutations that are associated with psoriasis may also be related to the gut disorders.

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How Does Arthritis Affect How I Respond To The Flu

People with certain types of arthritis, called inflammatory or systemic arthritis or autoimmune rheumatic disease, have a higher risk of getting flu-related complications, such as pneumonia. Inflammatory arthritis affects the immune system which controls how well your body fights off infections. Also, many medications given to treat inflammatory arthritis can weaken the immune system. People with weakened immune systems are at high risk for getting more severe illness and complications such as hospitalization with the flu. Rheumatoid arthritis and lupus are the most common types of inflammatory arthritis.

People with osteoarthritis, also called degenerative arthritis, are likely not at increased risk of complications from the flu unless they also have other high-risk conditions for flu such as asthma, diabetes, heart disease, or cancer. If you have one of these types of inflammatory arthritis, you may be at high risk for complications from the flu. You should discuss your risk for complications from the flu with your healthcare provider.

Types of Inflammatory Arthritis

  • Sarcoidosis
  • Polyarteritis nodosa

Arthritis medications that weaken the immune system

  • Steroids taken by mouth or intravenously, not applied to the skin or injected into a joint.
  • prednisone
  • prednisolone
  • tacrolimus

Can I Get The Flu Shot And Covid

Fall Means Flu Shot Season Is Here

According to the CDC, you can get the flu vaccine at the same time as the COVID-19 vaccine, including a third dose or booster dose of the COVID-19 vaccine. Past research has shown the way our bodies develop protection and possible side effects are generally similar, whether the vaccine is given alone or with another vaccine.

It is largely at the discretion of the individual, says S. Louis Bridges, Jr., MD, PhD, Physician-in-Chief and Chief of the Division of Rheumatology at the Hospital for Special Surgery. In general, co-administration of vaccines has been effective and safe over decades in adults and in children, and there is no evidence that giving flu vaccine and COVID-19 vaccine simultaneously raises any safety concerns.

There are advantages and disadvantages to consider, however. The advantage: Youll only need to go once for protection against two different vaccines and the vaccines will protect against infection sooner than if dosing of the vaccine is delayed, notes Dr. Bridges. The disadvantage: With two shots, side effects such as soreness at the site of injection, fever, and fatigue may be more common, he adds.

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Keep Practicing Mask Wearing Social Distancing And Good Hygiene

While experts agree that you need to get a flu shot, it doesnt mean you should stop taking other precautions to stay healthy this flu season.

Even after receiving the flu shot, its still important to take all the steps you can to avoid getting the flu, says Owensby.

So, get vaccinated, amp up your efforts to eat well and exercise, prioritize sleep, manage stress, and of course, practice a whole lot of hand washing and sanitizing.

How Can I Avoid Getting The Flu Or Giving The Flu To Others

The flu is spread from person-to-person by coughing or sneezing by people with influenza. Sometimes people may become infected by touching something such as a surface or object with flu viruses on it and then touching their mouth or nose. You can take simple actions to protect yourself and others from getting the flu:

  • Get a seasonal and 2009 H1N1 flu shot.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose, or mouth. Germs spread this way.
  • Try to avoid close contact with sick people.
  • If you are sick with flu-like illness, seek medical care early. Your health care provider can determine if you need to be treated with antiviral medication.
  • Keep away from others as much as possible to keep from making others sick. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of a fever-reducing medicine.

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The Link Between Psoriatic Arthritis And Heart Disease

Psoriatic arthritis is a chronic autoimmune condition causing inflammation of the skin and joints. But the problem doesn’t end there. Systemic inflammation throughout the body from psoriatic arthritis increases the risk of cardiovascular disease.

This article discusses PSA, its association with heart disease, and ways to lower risk.

Number One: You Need The Flu Shot Full Stop

Arthritis Of The Fingers – Everything You Need To Know – Dr. Nabil Ebraheim

Less than half of patients with rheumatoid arthritis and psoriatic arthritis get vaccinated for influenza, according to a recent study. But when you have inflammatory arthritis, your risk of getting the flu is higher if you get sick, the infection and potential for complications is more severe. Heres why, and what else you need to know to help you stay healthy this flu season:

Read Also: Can You Get A Flu Shot While Sick

Increased Risk Of Uvetis And Other Eye Problems

Having psoriatic arthritis ups your risk of uveitis a condition that causes inflammation of the uvea, or the middle layer of the eye, located under the white of the eye.

According to the National Psoriasis Foundation, about 7 percent of people with psoriatic arthritis will develop uveitis. If its not treated, uveitis can lead to vision loss.

The reasons for this higher risk are uncertain, but its likely the inflammation that causes joints to flare also can affect some of the tissues in the eye.

People with the gene for the human leukocyte antigen B27 may have a higher risk for psoriatic arthritis and uveitis, according to an article published in January 2016 in the Review of Optometry.

Other eye problems, such as glaucoma and cataracts, are also more common in people with psoriatic arthritis.

How Should I Use Simponi

Use Simponi exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

If you have ever had tuberculosis or hepatitis B, golimumab can cause these conditions to come back or get worse. You should be tested for these conditions before you start using golimumab.

Simponi is sometimes given as an infusion into a vein. A healthcare provider will give you this type of injection once every 4 to 8 weeks.

Simponi may also be injected under the skin once every 2 to 4 weeks. A healthcare provider may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine. Do not use this medicine if you don’t understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.

Prepare your injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

Your care provider will show you the best places on your body to inject Simponi. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Golimumab can weaken your immune system. Your blood will need to be tested often.

Store the medication in its original carton in the refrigerator, do not freeze. Protect from light.

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Increased Risk Of Pancreatitis And Diabetes

A study published in July 2016 in the journal PLoS One found that psoriatic disease is associated with a significantly increased risk of chronic pancreatitis, an inflammatory disease of the pancreas.

The researchers found that the incidence of chronic pancreatitis was roughly twofold in people with psoriasis compared with those without psoriasis. They also determined that psoriasis patients using nonsteroidal anti-inflammatory drugs and Trexall , commonly used to treat psoriatic arthritis, had a lower risk of developing chronic pancreatitis.

The pancreas produces insulin, which helps maintain the bodys blood glucose levels. If the pancreas isnt functioning properly, it can lead to type 1 or type 2 diabetes. A study published in February 2017 in the Journal of Rheumatology found that the prevalence of diabetes mellitus is higher in patients with psoriatic arthritis. The risk of developing diabetes was shown to increase with elevated levels of psoriatic arthritis activity.

How Are Steroids Used To Treat Psoriatic Arthritis

10 tips for managing psoriatic arthritis in cold weather


Corticosteroids are powerful anti-inflammatory drugs that relieve severe pain and swelling. You take them by mouth or inject them directly into a joint or muscle. They’re not the same as the muscle-building type of anabolic steroids. Prednisone is a common steroid. It can help for a short time, but it might make the skin rash worse. Doctors prescribe steroids only when you really need them. If you use them for a long time, you could have serious side effects such as brittle bones, weight gain, hypertension and diabetes.

Sharon Mayo, Health Educator, National Psoriasis Foundation

Alice Gottlieb, MD, PhD, Dermatologist-in-Chief, Tufts Medical Center

National Psoriasis Foundation: Psoriatic Arthritis Psoriatic Arthritis Treatments

American College of Rheumatology: NSAIDS: Nonsteroidal Anti-Inflammatory Drugs

American Academy of Dermatology: Guidelines of care for the management of psoriasis and psoriatic arthritis.

MedLine Plus Medical Encyclopedia: Diclofenac and misoprostol.

Johnston, BL and Conly, JM. Canadian Journal of Infectious Diseases and Medical Microbiology, July-August 2006.

UpToDate: “Treatment of psoriatic arthritis.”

Schett, G. Therapeutic Advances in Musculoskeletal Disease, October 2010.

FDA. FDA approves Inflectra, a biosimilar to Remicade. FDA approves Amjevita, a biosimilar to Humira.

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Vaccines Recommended For Psoriasis Patients

Patients diagnosed with psoriasis are at risk of infections owing to the nature of disease and immunosuppressive therapies . Therefore, the medical board of the National Psoriasis Foundation recommends vaccinations in compliance with recommendations of the Advisory Committee for Immunization Practices to prevent infections . Types of vaccines can be categorized as live and inactivated vaccines .

Inactivated or inert vaccines
Haemophilus influenza type b conjugate vaccine Herpes zoster

Pneumococcal Vaccines 13 And 23 Are They Free For People

Pneumococcal vaccines 13 and 23 are they free for people under 65 and with psoriatic arthritis and do I need both?

There are two types of vaccines that protect against either 13 or 23 types of pneumococcal bacteria.

The pneumococcal conjugate vaccine is recommended and provided free for adults at high risk of pneumococcal disease due to HIV infection or having had a stem cell transplant. It is also recommended by Canada’s National Advisory Committee on Immunization but not provided free for other adults with certain medical conditions. It is available for purchase for adults that want protection. Please discuss this further with your health care provider.

Pneumococcal Polysaccaride Vaccine is provided free for seniors 65 years and older and people with certain medical conditions. A one time booster is given after 5 years to people with certain medical conditions. You can find more information about who is eligible here.

Please contact your health care provider for further questions andd recommendations.

ImmunizeBC Nurse

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What Are The Symptoms Of The Flu

The symptoms of 2009 H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever.

What Are My Options

Should You Get the Flu Vaccine?

There have been many new drug approvals for psoriatic arthritis in recent years, so you should spend some time with your doctor discussing your options.

Injectable treatment means that the drug will be administered directly into your body, as opposed to an oral route, in which the medication is taken by mouth and digested.

Basically, there are two ways injectables are administered:

  • intravenous infusion, which delivers the medicine directly into a vein through a small plastic tube
  • needle injection into a muscle, which is an intramuscular injection, or into skin tissue, which is a subcutaneous injection

Methotrexate is one of the most commonly prescribed medications for psoriatic arthritis. Methotrexate is part of a drug class known as disease-modifying antirheumatic drugs . It can be taken by mouth, which is the more common method, but it can also be administered by injection.

A doctor may want to try methotrexate before moving on to more targeted therapies called biologics, or they may prescribe methotrexate along with a biologic agent.

There are many injectable biologic medications currently approved for psoriatic arthritis, including:

  • adalimumab
  • ixekizumab
  • secukinumab

Ask your doctor to review the similarities and differences between each of these medications. If your doctor already has a particular biologic in mind, ask them their reasons for choosing that one first.

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Its False That The Flu Shot Gives You The Flu

Sure, you may have heard otherwise from your mom or aunt or well-meaning, misinformed friend. But this is a common myth that is absolutely not true, says rheumatologist Vinicius Domingues, MD, CreakyJoints medical advisor and an assistant professor of medicine at Florida State University. Flu viruses that have been inactivated or killed are not infectious and cannot cause flu illness. What you may feel: sore and tender, along with redness and swelling, in the spot where you got the shot.

Do Rheumatology Health Professionals Need To Get A Flu Shot

Yes. CDC recommends all healthcare providers receive both the seasonal influenza vaccine every year and the 2009 H1N1 vaccine. Healthy persons who are infected with influenza virus, including those with subclinical infection, can transmit influenza virus to persons at higher risk for complications from influenza, such as patients with inflammatory rheumatic disease. Persons working in healthcare settings who should be vaccinated include physicians, nurses, other workers in both hospital and outpatient settings, medical emergency-response workers, employees of nursing home and long-term care facilities who have contact with patients or residents, and students in these professions who will have contact with patients.

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Vaccines And Flu Shots

A. Your vaccinations should be brought up to date before starting ENBREL. While you are taking ENBREL, you may be able to get some vaccines, including certain types of flu shots. You should not receive any live vaccines while taking ENBREL. Talk to your doctor before receiving vaccines, including flu shots, if you are taking ENBREL.

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