Rheumatoid arthritis (RA) is the most prevalent chronic, inflammatory arthritides affecting the synovial membrane of multiple diarthrodial joints. Although its etiology has not been completely clarified, dysregulation of the immune system is evident with a preponderance of inflammatory cytokines and immune cells with joints. The risk of infection is increased in RA patients, due to both the inflammatory process and the immunosuppressive therapy administered for disease control. Vaccines are a powerful tool in the prevention of infectious disease, yet their safety and efficacy in RA patients differ from those in the healthy population as a result of their immune milieu. The general efficacy of vaccines is considered satisfactory in RA patients despite the attenuated immune response. Vaccines have sporadically been implicated as a trigger for the initiation of RA, although large epidemiological studies have not supported this association. Finally, vaccines are a potential tool in immune-modulation, and they are currently being tested as therapy for RA patients. In this review, we discuss the role of vaccines in RA etiology, the safety and efficacy of different vaccines in RA patients, and the possible future role of vaccines in RA therapy.
- European league against Rheumatism (EULAR)
- Hepatitis B virus (HBV) vaccination
- Rheumatoid arthritis (RA)
- Varicella zoster virus (VZV)