TY - JOUR
T1 - Flares in IIMs and the timeline following COVID-19 vaccination
T2 - a combined analysis of the COVAD-1 and -2 surveys
AU - COVAD Study Group
AU - Naveen, R.
AU - Sen, Parikshit
AU - Griger, Zoltán
AU - Day, Jessica
AU - Joshi, Mrudula
AU - Nune, Arvind
AU - Nikiphorou, Elena
AU - Saha, Sreoshy
AU - Tan, Ai Lyn
AU - Shinjo, Samuel Katsuyuki
AU - Ziade, Nelly
AU - Velikova, Tsvetelina
AU - Milchert, Marcin
AU - Jagtap, Kshitij
AU - Parodis, Ioannis
AU - Gracia-Ramos, Abraham Edgar
AU - Cavagna, Lorenzo
AU - Kuwana, Masataka
AU - Knitza, Johannes
AU - Chen, Yi Ming
AU - Makol, Ashima
AU - Agarwal, Vishwesh
AU - Patel, Aarat
AU - Pauling, John D.
AU - Wincup, Chris
AU - Barman, Bhupen
AU - Tehozol, Erick Adrian Zamora
AU - Serrano, Jorge Rojas
AU - García-De La Torre, Ignacio
AU - Colunga-Pedraza, Iris J.
AU - Merayo-Chalico, Javier
AU - Chibuzo, Okwara Celestine
AU - Katchamart, Wanruchada
AU - Goo, Phonpen Akarawatcharangura
AU - Shumnalieva, Russka
AU - Hoff, Leonardo Santos
AU - El Kibbi, Lina
AU - Halabi, Hussein
AU - Vaidya, Binit
AU - Shaharir, Syahrul Sazliyana
AU - Hasan, A. T.M.Tanveer
AU - Dey, Dzifa
AU - Gutiérrez, Carlos Enrique Toro
AU - Caballero-Uribe, Carlo V.
AU - Lilleker, James B.
AU - Salim, Babur
AU - Gheita, Tamer
AU - Chatterjee, Tulika
AU - Distler, Oliver
AU - Ugarte-Gil, Manuel Francisco
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Objectives: Disease flares in the post-coronavirus disease 2019 (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 minimal clinically significant improvement difference worsening of Patient-Reported Outcomes Measurement Information System (PROMIS) PROMISPF10a score. Risk factors of flares were analysed using regression models. Results: Of 15 165 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) to (d), respectively, with a median time to flare of 71.5 (10.7-235) days, similar to AIRDs. Patients with active IIMs pre-vaccination (OR 1.2; 95% CI 1.03, 1.6, P = 0.025) were prone to flares, while those receiving rituximab (OR 0.3; 95% CI 0.1, 0.7, P = 0.010) and AZA (OR 0.3, 95% CI 0.1, 0.8, P = 0.016) were at lower risk. Female gender and comorbidities predisposed to flares requiring changes in IS. Asthma (OR 1.62; 95% CI 1.05, 2.50, P = 0.028) and higher pain visual analogue score (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.
AB - Objectives: Disease flares in the post-coronavirus disease 2019 (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 minimal clinically significant improvement difference worsening of Patient-Reported Outcomes Measurement Information System (PROMIS) PROMISPF10a score. Risk factors of flares were analysed using regression models. Results: Of 15 165 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) to (d), respectively, with a median time to flare of 71.5 (10.7-235) days, similar to AIRDs. Patients with active IIMs pre-vaccination (OR 1.2; 95% CI 1.03, 1.6, P = 0.025) were prone to flares, while those receiving rituximab (OR 0.3; 95% CI 0.1, 0.7, P = 0.010) and AZA (OR 0.3, 95% CI 0.1, 0.8, P = 0.016) were at lower risk. Female gender and comorbidities predisposed to flares requiring changes in IS. Asthma (OR 1.62; 95% CI 1.05, 2.50, P = 0.028) and higher pain visual analogue score (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.
KW - COVID-19 vaccines
KW - disease exacerbation
KW - idiopathic inflammatory myopathies
KW - patient-reported outcomes
UR - http://www.scopus.com/inward/record.url?scp=85180733005&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kead180
DO - 10.1093/rheumatology/kead180
M3 - Artículo
C2 - 37084267
AN - SCOPUS:85180733005
SN - 1462-0324
VL - 63
SP - 127
EP - 139
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 1
ER -