4.7 Article

Baseline factors associated with self-reported disease flares following COVID-19 vaccination among adults with systemic rheumatic disease: results from the COVID-19 global rheumatology alliance vaccine survey

期刊

RHEUMATOLOGY
卷 61, 期 SI2, 页码 SI143-SI150

出版社

OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keac249

关键词

COVID-19; vaccine; disease flare; systemic rheumatic diseases

资金

  1. Intramural Research Program of the National Institutes of Health
  2. National Institute of Environmental Health Sciences [Z01 ES101074]
  3. National Institute of Environmental Health Sciences (Clinical Research Branch)
  4. European Alliance of Associations for Rheumatology
  5. American College of Rheumatology Research and Education Foundation
  6. NIEHS [HHSN273201600002I]

向作者/读者索取更多资源

The study found that disease flares requiring changes in treatment after COVID-19 vaccination were uncommon among patients with systemic rheumatic diseases. Certain SRD types like systemic lupus erythematosus, psoriatic arthritis, and polymyalgia rheumatica were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds. The Oxford-AstraZeneca vaccine, a prior reaction to a non-COVID-19 vaccine, and female sex were identified as potential risk factors for disease flares following vaccination.
Objective To examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD). Methods An international study was conducted from 2 April to 16 August 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression. Results Flares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95% CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95% CI 1.20, 3.18) and polymyalgia rheumatica (OR 1.94, 95% CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95% CI 0.31-0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95% CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95% CI 1.76, 3.54) and female sex (OR 2.71, 95% CI 1.55, 4.72). Conclusion SRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts.

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