Infectious Disease

Disease flares requiring therapy change ‘relatively uncommon’ after COVID-19 vaccination

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Rider reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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Systemic rheumatic disease flares requiring therapy changes after COVID-19 vaccination appear to be uncommon, according to data published in Rheumatology.

“We were interested in how patients with systemic rheumatic diseases would do after receiving COVID-19 vaccines, particularly in whether they experienced disease flares requiring a change in their therapies, and if there were any factors associated with disease flare in receiving these vaccines,” Lisa G. Rider, MD, the head of the environmental autoimmunity group in the clinical research branch of the NIH’s National Institute of Environmental Health Sciences, told Healio. “We met with investigators from the COVID-19 Global Rheumatology Alliance and were invited to help with their new questionnaire on COVID-19 vaccines.”

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Systemic rheumatic disease flares requiring therapy changes after COVID-19 vaccination appear to be uncommon, according to data.

To analyze self-reported flares among patients with systemic rheumatic diseases after vaccination for COVID-19, Rider and colleagues conducted a retrospective study examining data collected by the COVID-19 Global Rheumatology Alliance. Data were collected from patients by way of an online survey promoted through support groups and social media.

In the survey, patients reported rheumatoid disease type and duration. Patients with multiple rheumatic diseases classified their conditions via a hierarchy.

The survey asked patients who had received at least one dose of a COVID-19 vaccine if they experienced any serious reactions. Serious vaccine reactions were defined as lasting for at least 2 days and occurring within 2 months of vaccine administration. The study’s primary outcome was the presence of a self-reported flare of an existing disease requiring a change in therapy.

In all, the analysis included survey results from 5,619 patients with systemic rheumatic diseases who received at least one dose of a COVID-19 vaccine. The median age was 55.5 years, and most participants were female and white.

According to the researchers, flares that required an alteration to medication were reported in 4.9% of respondents. Systemic lupus erythematosus (OR = 1.51; 95% CI, 1.03-2.2), psoriatic arthritis (OR = 1.95; 95% CI, 1.2-3.18) and polymyalgia rheumatica (OR = 1.94; 95% CI, 1.08-2.48) were associated with a higher likelihood of disease flare compared with rheumatoid arthritis. Idiopathic inflammatory myopathies were associated with a lower risk for flare (OR = 0.54; 95% CI, 0.31-0.96), compared with RA.

In addition, the Oxford-AstraZeneca vaccine was associated with a higher likelihood of flares compared with the Pfizer-BioNTech vaccine (OR = 1.44; 95% CI, 1.07-1.95).

“In a large international sampling of rheumatic disease patients, we learned that disease flares requiring a change in treatment were relatively uncommon in patients with a variety of systemic rheumatic diseases, at a reported frequency of 4.9%,” Rider said. “The Oxford-AstraZeneca vaccine was associated with a higher odds of flare relative to the Pfizer-BioNTech mRNA vaccine, and prior reaction to a non-COVID vaccine and female gender were also associated with higher odds of flare, although these findings should be confirmed in other cohorts.”

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COVID-19 and Rheumatology

COVID-19 and Rheumatology

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