Risk of disseminated tuberculosis and other infections after neonatal Bacillus Calmette–Guérin vaccination in infants with in-utero exposure to tumor necrosis factor-α inhibitors - Scorecard - MDSpire
Advertisement
Risk of disseminated tuberculosis and other infections after neonatal Bacillus Calmette–Guérin vaccination in infants with in-utero exposure to tumor necrosis factor-α inhibitors
Clinical Scorecard: Evaluating the Risk of Disseminated Tuberculosis and Other Infections Following Neonatal Bacillus Calmette–Guérin Vaccination in Infants Exposed In Utero to Tumor Necrosis Factor-α Inhibitors
At a Glance
Category
Detail
Condition
Infection risk following BCG vaccination in infants exposed to TNF-α inhibitors
Key Mechanisms
TNF-α inhibitors can cross the placenta and may affect fetal immune response.
Target Population
Infants born to mothers with autoimmune rheumatic diseases treated with TNF-α inhibitors.
Care Setting
Tertiary hospital in Qatar.
Key Highlights
63 infants exposed to TNF-α inhibitors were studied.
49 infants (77.8%) received BCG vaccination within the first year.
No cases of disseminated tuberculosis were reported.
Over half of the infants experienced at least three infections.
Certolizumab was the most frequently prescribed TNF-α inhibitor.
Guideline-Based Recommendations
Diagnosis
Monitor for infections and adverse reactions post-BCG vaccination.
Management
Defer BCG vaccination for infants exposed to TNF-α inhibitors after 20 weeks of gestation for certain agents.
Monitoring & Follow-up
Observe infants for signs of infection and adverse reactions to the vaccine.
Risks
Potential for increased risk of infections in infants exposed to TNF-α inhibitors.
Patient & Prescribing Data
Infants born to mothers with autoimmune rheumatic diseases.
Certolizumab has negligible placental transfer, allowing for standard vaccination timelines.
Clinical Best Practices
Assess maternal medication history for TNF-α inhibitors during pregnancy.
Follow guidelines for timing of BCG vaccination based on maternal TNF-α inhibitor exposure.
