Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and 2 surveys
- Author(s)
- Naveen, R; Sen, P; Griger, Z; Day, J; Joshi, M; Nune, A; Nikiphorou, E; Saha, S; Tan, AL; Shinjo, SK; Ziade, N; Velikova, T; Milchert, M; Jagtap, K; Parodis, I; Edgar Gracia-Ramos, A; Cavagna, L; Kuwana, M; Knitza, J; Chen, YM; Makol, A; Agarwal, V; Patel, A; Pauling, JD; Wincup, C; Barman, B; Zamora Tehozol, EA; Serrano, JR; García-De La Torre, I; Colunga-Pedraza, IJ; Merayo-Chalico, J; Chibuzo, OC; Katchamart, W; Goo, PA; Shumnalieva, R; Hoff, LS; Kibbi, EL; Halabi, H; Vaidya, B; Shaharir, SS; Hasan, Atmt; Dey, D; Gutiérrez, CET; Caballero-Uribe, CV; Lilleker, JB; Salim, B; Gheita, T; Chatterjee, T; Distler, O; Saavedra, MA; Chinoy, H; Agarwal, V; Aggarwal, R; Gupta, L;
- Journal Title
- Rheumatology
- Publication Type
- epub ahead of print
- 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 (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 Azathioprine (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 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.
- Publisher
- Oxford Academic
- Keywords
- COVID-19 Vaccines; Disease Exacerbation; Idiopathic Inflammatory Myopathies; Patient Reported Outcomes
- Research Division(s)
- Inflammation
- PubMed ID
- 37084267
- Publisher's Version
- https://doi.org/10.1093/rheumatology/kead180
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2023-05-01 02:16:46
Last Modified: 2023-05-03 09:59:03