{"id":1841,"date":"2025-05-28T16:55:29","date_gmt":"2025-05-28T14:55:29","guid":{"rendered":"https:\/\/resemedicin.se\/svarigar\/?p=1841"},"modified":"2025-05-28T16:55:31","modified_gmt":"2025-05-28T14:55:31","slug":"2025-05-28-shingrix-till-patient-som-star-pa-rituximab","status":"publish","type":"post","link":"https:\/\/resemedicin.se\/svarigar\/2025-05-28-shingrix-till-patient-som-star-pa-rituximab\/","title":{"rendered":"2025-05-28 Shingrix\u00ae till patient som st\u00e5r p\u00e5 rituximab?"},"content":{"rendered":"\n<p><strong>Fr\u00e5ga:<\/strong> Har f\u00f6rst\u00e5tt att det inte \u00e4r l\u00f6nt att vaccinera en patient som st\u00e5r p\u00e5 rituximab med Shingrix\u00ae. \u00c4r det s\u00e5?<\/p>\n\n\n\n<p><strong>Svar: <\/strong>Inte riktigt s\u00e5 enkelt (det \u00e4r s\u00e4llan det).&nbsp;Ett flertal studier har visat att personer som behandlats med rituximab (Mabthera\u00ae, m.fl.) har&nbsp;<strong>kraftigt reducerad serokonversion<\/strong>&nbsp;(utveckling av m\u00e4tbara antikroppar) efter vaccination. En studie visade t.ex. att endast 5\u201320 % av patienter med reumatoid artrit som behandlats med rituximab utvecklade antikroppar efter mRNA COVID-19-vaccin, j\u00e4mf\u00f6rt med &gt;90 % i kontrollgruppen.<br>Den immunosuppressiva effekten kvarst\u00e5r&nbsp;<strong>l\u00e5ngt efter avslutad behandling<\/strong><strong>&nbsp;<\/strong>\u2013 ofta i&nbsp;<strong>6\u201312 m\u00e5nader<\/strong>. B\u00e4sta vaccinsvaret ses om vaccination ges&nbsp;<strong>minst 6 m\u00e5nader efter sista rituximabdos<\/strong>&nbsp;och&nbsp;<strong>minst 4 veckor f\u00f6re n\u00e4sta dos<\/strong>.<\/p>\n\n\n\n<p>Trots svagt antikroppssvar kan dock T-cellssvaret (den cellul\u00e4ra immuniteten) ibland vara intakt, och d\u00e5 \u00e4nd\u00e5 ge ett visst skydd om man inte kan pausa rituximab-behandlingen. S\u00e5 det \u00e4r inte helt svart eller vitt<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fr\u00e5ga: Har f\u00f6rst\u00e5tt att det inte \u00e4r l\u00f6nt att vaccinera en patient som st\u00e5r p\u00e5 rituximab med Shingrix\u00ae. \u00c4r det s\u00e5? Svar: Inte riktigt s\u00e5 enkelt (det \u00e4r s\u00e4llan det).&nbsp;Ett flertal studier har visat att personer som behandlats med rituximab (Mabthera\u00ae, m.fl.) har&nbsp;kraftigt reducerad serokonversion&nbsp;(utveckling av m\u00e4tbara antikroppar) efter vaccination. En studie visade t.ex. att &hellip; <a href=\"https:\/\/resemedicin.se\/svarigar\/2025-05-28-shingrix-till-patient-som-star-pa-rituximab\/\" class=\"more-link\">Forts\u00e4tt l\u00e4sa<span class=\"screen-reader-text\"> \u201d2025-05-28 Shingrix\u00ae till patient som st\u00e5r p\u00e5 rituximab?\u201d<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1841","post","type-post","status-publish","format-standard","hentry","category-svar-igar"],"modified_by":"Karl Ekdahl","jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/1841","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/comments?post=1841"}],"version-history":[{"count":1,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/1841\/revisions"}],"predecessor-version":[{"id":1842,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/posts\/1841\/revisions\/1842"}],"wp:attachment":[{"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/media?parent=1841"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/categories?post=1841"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/resemedicin.se\/svarigar\/wp-json\/wp\/v2\/tags?post=1841"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}