Patients with immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis and inflammatory bowel disease, are at increased risk of infection. International guidelines recommend vaccination to limit this risk of infection, although live attenuated vaccines are contraindicated once immunosuppressive therapy has begun. Biologic therapies used to treat IMIDs target the immune system to stop chronic pathogenic process but may also attenuate the protective immune response to vaccines. Here, we review the current knowledge regarding vaccine responses in IMID patients receiving treatment with biologic therapies, with a focus on the interleukin (IL)-12/23 inhibitors. B cell-depleting therapies, such as rituximab, strongly impair vaccines immunogenicity, and tumor necrosis factor (TNF) inhibitors and the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) fusion protein abatacept are also associated with attenuated antibody responses, which are further diminished in patients taking concomitant immunosuppressants. On the other hand, integrin, IL-6, IL-12/23, IL-17, and B-cell activating factor (BAFF) inhibitors do not appear to affect the immune response to several vaccines evaluated. Importantly, treatment with biologic therapies in IMID patients is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or developing severe disease. However, the efficacy of SARS-CoV-2 vaccines on IMID patients may be reduced compared with healthy individuals. The impact of biologic therapies on the response to SARS-CoV-2 vaccines seems to replicate what has been described for other vaccines. SARS-CoV-2 vaccination appears to be safe and well tolerated in IMID patients. Attenuated but, in general, still protective responses to SARS-CoV-2 vaccination in the context of certain therapies warrant current recommendations for a third primary dose in IMID patients treated with immunosuppressive drugs.

Purpose: To provide real-world evidence of the clinical characteristics and outcomes of localized and locally advanced prostate cancer patients (LPC/LAPC). Materials & methods: Observational and retrospective analysis using secondary data from electronic health records (EHR) of prostate cancer (PC) patients in eight Spanish hospitals (2014–2018). Data was extracted and analyzed using EHRead® technology, based on natural language processing and machine learning. LPC/LAPC patients were included and stratified by risk and by first treatment received. Results: Twenty-two thousand one hundred sixty-six PC patients were identified,14,434 (65.1%) were classified as LPC/LAPC. Among them, 5,331 incident patients with sufficient data were selected for outcome analysis (real world overall survival [rwOS], metastasis and event free survival [MFS, EFS]) and were followed for a median time of 2.3 years. 36.5% were classified as LPC intermediate risk (IR), 26.0% LPC high risk (HR), 7.3% LPC low risk (LR), 5.9% LAPC, and 24.2% unknown risk. First treatment received was radiotherapy (RT) in 40.7%, radical prostatectomy (RP) in 37.1%, active surveillance (AS)/watchful waiting (WW) in 6.4%, brachytherapy (BT) in 4.2%, and androgen deprivation therapy monotherapy (ADT only) in 3.3%. rwOS and MFS worsened as risk increased. Patients treated with ADT only presented the worst baseline characteristics, showing limited clinical outcomes. The 36-month rwOS was 91% for LAPC patients, 93% for HR-LPC, 97% for IR-LPC, and 98% for LR-LPC. Conclusions: Despite using treatment with curative intent, patients experienced oncological events within a median of less than three years post-diagnosis. Our findings emphasize the need for risk stratification, and proactive strategies to improve clinical outcomes.