HealthDay News — Overall, 2.8% of a national cohort of commercially insured US adults meet criteria for drug-induced immunosuppression, of whom 67.7% receive oral corticosteroids, according to a research letter published online May 20 in JAMA Network Open.

Beth I. Wallace, MD, from the University of Michigan Medical School in Ann Arbor, and colleagues conducted a cross-sectional study using direct pharmaceutical claims to describe the prevalence of drug-induced immunosuppression among 3,169,441 continuously enrolled patients.

The researchers found that 2.8% of the participants met the criteria for drug-induced immunosuppression during the period from January 1, 2018, through December 31, 2019. Most of those receiving immunosuppressive drugs were older (median age, 53 years) and were women (61.2%). Prednisone, methotrexate, and methylprednisolone were the most commonly prescribed drugs (53.0, 24.5, and 21.6%, respectively), and together, these drugs were used by 62.5% of patients. Overall, 67.7% of patients received oral corticosteroids, and 40.9% received oral corticosteroids for 30 days or longer within a period of 365 days. Malignant neoplasms, immune-mediated conditions, and inflammatory skin conditions were the most common immunosuppression-associated diagnosis categories (73.8, 68.8, and 38.8%, respectively).

“We’re starting to realize that people taking immunosuppressive drugs may have a slower, weaker response to COVID vaccination, and, in some cases, might not respond at all,” Wallace said in a statement. “We don’t have a full picture on how these drugs affect the vaccine’s effectiveness, so it’s difficult to formulate guidelines around vaccinating these patients.”


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Several authors disclosed ties to the biopharmaceutical and medical device industries, and two authors were included on patents.

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