AXIAL SPONDYLOARTHRITIS, AGE and MALE GENDER IMPACT COVID VACCINATION AES MORE THAN RHEUMATOID ARTHRITIS

ABSTRACT

Background: Rheumatologists recommend vaccination in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) patients, but there are few studies on the occurrence of adverse events (AEs), particularly worsening disease related activity and unrelated immune reactions in these groups. Objectives: To evaluate the uptake of COVID vaccination in RA and axSpA patients, compare the frequency of AEs, and identify risk factors associated with vaccine AEs in two prospective cohorts comprised of these patients. Methods: The IMPACT study is a monthly survey of two prospective cohorts of established RA and axSpA patients in northern Alberta, Canada from November 2020-2021 who answered at least one or more Redcap surveys through de-iden-tifed email link surveying demographics, disease characteristics, COVID symptoms, treatment of RA and axSpA, health care utilization, vaccination status, vaccine AEs and use of cannabis. Univariate analyses evaluated independent variables associated with the dependent variables of (1) any AE, (2) any severe AE, (3) any arthritis fare, and (4) any severe arthritis fare, followed by multi-variate analyses of these four dependant variables using all clinically relevant variables from the univariate analysis. Results: 773/2167 patients (RA 574, axSpA 197) responded to at least one survey. 32/663 (5%) were single vaccinated, 631 (95%) double vaccinated and 230 (54%) triple vaccinated with 80% receiving Pfzer, 24% Moderna, 28% Astra-Zeneca and 30% 'other'. 456 (69%) reported at least one AE (Figure 1) with 21 (3%) patients seeing a physician for their AE. Increased age was associated with all AEs. RA patients had lower reported AEs versus axSpA patients for all AE defnitions except for severe arthritis fares. Generally, males reported worse AEs (Table 1). 'Any arthritis fare' was lower in patients reporting cannabis use. Conclusion: RA and axSpA patients showed high uptake of COVID vaccination with largely minor AEs. Older age and male gender were associated with more general and arthritis specifc AEs. The association of any AE and/or arthritis-spe-cifc AEs in SpA versus RA patients is a novel fnding which may correlate with the male predominance of SpA. The association of cannabis with fewer arthritis AEs may refect the nociceptive properties of cannabis.