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Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and 2 surveys.
Naveen, R; Sen, Parikshit; Griger, Zoltán; Day, Jessica; Joshi, Mrudula; Nune, Arvind; Nikiphorou, Elena; Saha, Sreoshy; Tan, Ai Lyn; Shinjo, Samuel Katsuyuki; Ziade, Nelly; Velikova, Tsvetelina; Milchert, Marcin; Jagtap, Kshitij; Parodis, Ioannis; Edgar Gracia-Ramos, Abraham; Cavagna, Lorenzo; Kuwana, Masataka; Knitza, Johannes; Chen, Yi Ming; Makol, Ashima; Agarwal, Vishwesh; Patel, Aarat; Pauling, John D; Wincup, Chris; Barman, Bhupen; Zamora Tehozol, Erick Adrian; Serrano, Jorge Rojas; García-De La Torre, Ignacio; Colunga-Pedraza, Iris J; Merayo-Chalico, Javier; Chibuzo, Okwara Celestine; Katchamart, Wanruchada; Goo, Phonpen Akawatcharangura; Shumnalieva, Russka; Hoff, Leonardo Santos; Kibbi, El Lina; Halabi, Hussein; Vaidya, Binit; Shaharir, Syahrul Sazliyana; Hasan, A T M Tanveer; Dey, Dzifa; Gutiérrez, Carlos Enrique Toro; Caballero-Uribe, Carlo Vinicio; Lilleker, James B; Salim, Babur; Gheita, Tamer; Chatterjee, Tulika; Distler, Oliver; Saavedra, Miguel A.
  • Naveen R; Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
  • Sen P; Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, Delhi-110002, India.
  • Griger Z; Division of Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
  • Day J; Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia.
  • Joshi M; Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052 Australia.
  • Nune A; Department of Medical Biology, University of Melbourne, Parkville, VIC 3052 Australia.
  • Nikiphorou E; Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India.
  • Saha S; Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN, UK.
  • Tan AL; Centre for Rheumatic Diseases, King's College London, London, UK.
  • Shinjo SK; Rheumatology Department, King's College Hospital, London, UK.
  • Ziade N; Mymensingh Medical College, Mymensingh, Bangladesh.
  • Velikova T; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
  • Milchert M; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
  • Jagtap K; Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Parodis I; Rheumatology Department, Saint-Joseph University, Beirut, Lebanon.
  • Edgar Gracia-Ramos A; Rheumatology Department, Hotel-Dieu de France Hospital, Beirut, Lebanon.
  • Cavagna L; Medical Faculty, Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria.
  • Kuwana M; Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, ul Unii Lubelskiej 1, 71-252, Szczecin, Poland.
  • Knitza J; Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India.
  • Chen YM; Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
  • Makol A; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
  • Agarwal V; Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, C.P. 02990 Mexico City, Mexico.
  • Patel A; Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Università degli studi di Pavia, Pavia, Lombardy, Italy.
  • Pauling JD; Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.
  • Wincup C; Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
  • Barman B; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
  • Zamora Tehozol EA; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Serrano JR; Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.
  • García-De La Torre I; Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India.
  • Colunga-Pedraza IJ; Bon Secours Rheumatology Center and Division of Pediatric Rheumatology, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA.
  • Merayo-Chalico J; Bristol Medical School Translational Health Sciences, University of Bristol, UK.
  • Chibuzo OC; Department of Rheumatology, North Bristol NHS Trust, Bristol, UK.
  • Katchamart W; Department of Rheumatology, Division of Medicine, Rayne Institute, University College London, UK.
  • Goo PA; Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK.
  • Shumnalieva R; Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Guwahati, India.
  • Hoff LS; Rheumatology, Medical Care & Research, Centro Medico Pensiones Hospital, Instituto Mexicano del Seguro Social Delegación Yucatán, Yucatán, Mexcio.
  • Kibbi EL; Rheumatologist and Clinical Investigator, Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
  • Halabi H; Departamento de Inmunología y Reumatología, Hospital General de Occidente and Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
  • Vaidya B; Rheumatology, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico.
  • Shaharir SS; Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Hasan ATMT; Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla/University of Nigeria, Enugu Campus, Enugu, Nigeria.
  • Dey D; Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  • Gutiérrez CET; Department of Medicine, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.
  • Caballero-Uribe CV; Department of Rheumatology, Clinic of Rheumatology, University Hospital "St. Ivan Rilski",Medical University-Sofia, Bulgaria.
  • Lilleker JB; School of Medicine, Universidade Potiguar (UnP), Brazil.
  • Salim B; Rheumatology Unit, Internal Medicine Department, Specialized Medical Center, Riyadh, Saudi Arabia.
  • Gheita T; Department of Internal Medicine, Section of rheumatology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
  • Chatterjee T; National Center for Rheumatic Diseases (NCRD), Ratopul, Kathmandu, Nepal.
  • Distler O; Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur.
  • Saavedra MA; Department of Rheumatology, Enam Medical College & Hospital, Dhaka, Bangladesh.
Rheumatology (Oxford) ; 2023 Apr 21.
Article in English | MEDLINE | ID: covidwho-2300779
ABSTRACT

OBJECTIVES:

Disease flares in the post COVID-19 vaccination period represent a prominent concern, though risk factors are poorly understood. We studied these flares among patients with idiopathic inflammatory myopathies (IIMs) and other autoimmune rheumatic diseases (AIRDs).

METHODS:

The COVAD-1 and -2 global surveys were circulated in early 2021 and 2022 respectively, and we captured demographics, comorbidities, AIRDs details, COVID-19 infection history, and vaccination details.Flares of IIMs were defined as a. patient self-reported, b. immunosuppression (IS) denoted, c. clinical sign directed, and d. with >7.9-point MCID worsening of PROMISPF10a score. Risk factors of flares were analyzed using regression models.

RESULTS:

Of 15165 total respondents, 1278 IIMs (age 63 years, 70.3% female, 80.8% Caucasians), and 3453 AIRDs were included. Flares of IIM were seen in 9.6%, 12.7%, 8.7%, and 19.6% patients by definitions a-d respectively with a median time to flare of 71.5 (10.7-235) days, similar to AIRDs. Patients with active IIMs pre-vaccination (OR1.2; 95%CI1.03-1.6, p = 0.025) were prone to flares, while those receiving Rituximab (OR0.3; 95%CI0.1-0.7, p = 0.010) and Azathioprine (OR0.3, 95%CI0.1-0.8, p = 0.016) were at lower risk. Female gender and comorbidities predisposed to flares requiring changes in immunosuppression. Asthma (OR 1.62; 95%CI 1.05-2.50, p = 0.028) and higher pain VAS (OR 1.19; 95%CI 1.11-1.27, p < 0.001) were associated with disparity between self-reported and IS-denoted flares.

CONCLUSION:

A diagnosis of IIMs confers an equal risk of flares in the post COVID-19 vaccination period to AIRDs, with active disease, female gender, and comorbidities conferring a higher risk. Disparity between patient and physician reported outcomes represents a future avenue for exploration.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid / Vaccines Language: English Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: Rheumatology

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid / Vaccines Language: English Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: Rheumatology