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Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

C. Lebrun 1 S. Vukusic 2, 3, * V. Abadie C. Achour F. Ader 4 H. Alchaar A. Alkhedr F. Andreux 5 G. Androdias R. Arjmand Bertrand Audoin 6 D. Audry D. Aufauvre C. Autreaux X. Ayrignac 7 M. Bailbe M. Benazet C. Bensa D. Bensmail Eric Berger P. Bernady Y. Bertagna D. Biotti A. Blanchard-Dauphin Jérémie Bonenfant 8 M. Bonnan B. Bonnemain F. Borgel E. Botelho-Nevers 9 S. Boucly Bertrand Bourre C. Boutière 10 P. Branger D. Brassat 6 S. Bresch 11 V. Breuil 12 Bruno Brochet 6 H. Brugeilles P. Bugnon Philippe Cabre Jean-Philippe Camdessanché C. Carra-Dalière Olivier Casez J.-M. Chamouard B. Chassande P. Chataignier M. Chbicheb A. Chenet 13 Jonathan Ciron Pierre Clavelou 6 M. Cohen 14 R. Colamarino N. Collongues 6 I. Coman P.-R. Corail S. Courtois M. Coustans 15 Alain Créange 16 E. Creisson N. Daluzeau C. Davenas J. de Seze 6 Marc Debouverie 17 R. Depaz N. Derache L. Divio X. Douay C. Dulau F. Durand-Dubief 18 G. Edan 15 Z. Elias O. Fagniez M. Faucher J.-M. Faucheux M. Fournier 19 A. Gagneux-Brunon 9 P. Gaida P. Galli P. Gallien J. Gaudelus 20 D. Gault 21 A. Gayou M. Genevray A. Gentil J. Gere L. Gignoux M. Giroux P. Givron O. Gout 22 J. Grimaud A.-M. Guennoc N. Hadhoum P. Hautecoeur Olivier Heinzlef M. Jaeger S. Jeannin L. Kremer 23 A. Kwiatkowski Pierre Labauge 6 Céline Labeyrie S. Lachaud I. Laffont 24 C. Lanctin-Garcia J. Lannoy L. Lanotte David A. Laplaud 25 D. Latombe M. Lauxerois Emmanuelle Le Page 8 Christine Lebrun-Frenay 26 P. Lejeune P. Lejoyeux B. Lemonnier Emmanuelle Leray 27, 28, 29 C.-M. Loche C. Louapre 30 Catherine Lubetzki 31 A. Maarouf 6 B. Mada L. Magy 6 E. Maillart 32 E. Manchon R. Marignier 3 P. Marque G. Mathey 17 A. Maurousset C. Mekies M. Merienne 23 L. Michel A.-M. Milor X. Moisset 33 Alexis Montcuquet Thibault Moreau N. Morel M. Moussa J.-P. Naudillon M. Normand P. Olive J.-C. Ouallet Olivier Outteryck C. Pacault C. Papeix 32 Ivania Patry 34 D. Peaureaux Jean Pelletier 35 B. Pichon 36 S. Pittion E. Planque M.-C. Pouget V. Pourcher 37 C. Radot I. Robert F. Rocher A. Ruet 38 C. Saint-Val J.-Y. Salle A. Salmon E. Sartori S. Schaeffer B. Stankhof F. Taithe 39 Eric Thouvenot 6 C. Tizon Ayman Tourbah 40 P. Tourniaire M. Vaillant 41 Patrick Vermersch 6 S. Vidil A. Wahab M.-H. Warter S. Wiertlewski 42 B. Wiplosz B. Wittwer C. Zaenker H. Zephir 6 
* Corresponding author
18 RMN et optique : De la mesure au biomarqueur
CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
Abstract : Objectives: To establish recommendations on immunization for patients with multiple sclerosis (MS).Background: Vaccines have been suspected in the past to trigger MS and relapses. With the extension of the immunoactive treatment arsenal, other concerns have been raised more recently about an increased risk of infection or a decreased effectiveness of immunization in immunosuppressed patients.Methods: The French Group for Recommendations into Multiple Sclerosis (France4MS) performed a systematic search of papers in Medline and other university databases (January 1975-June 2018). The RAND/UCLA appropriateness method was chosen to review the scientific literature and to formalize the degree of agreement among experts on 5 clinical questions related to immunization and MS. Readers from the steering committee conducted a systematic analysis, wrote a critical synthesis and prepared a list of proposals that were evaluated by a rating group of 28 MS experts. The final version of the recommendations was finally reviewed by a reading group of 110 health care professionals and classified as appropriate, inappropriate or uncertain.Results: Neurologists should verify the vaccination status as soon as MS is diagnosed and before disease-modifying treatments (DMTs) are introduced. The French vaccination schedule applies to MS patients and seasonal influenza vaccination is recommended. In the case of treatment-induced immunosuppression, MS patients should be informed about the risk of infection and the vaccination standards of the French High Council of Health should be applied. Live attenuated vaccines are contra-indicated in patients recently treated with immunosuppressive drugs, including corticosteroids; other vaccines can be proposed whatever the treatment, but their effectiveness may be partly reduced with some drugs.Conclusion: Physicians and patients should be aware of the updated recommendations for immunizations of patients with MS.
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Submitted on : Friday, April 17, 2020 - 5:14:19 PM
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C. Lebrun, S. Vukusic, V. Abadie, C. Achour, F. Ader, et al.. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Revue Neurologique, Elsevier Masson, 2019, 175 (6), pp.341-357. ⟨10.1016/j.neurol.2019.04.001⟩. ⟨hal-02546158⟩



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