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Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period—a cross-sequential study based on COVAD surveys

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Title: Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period—a cross-sequential study based on COVAD surveys
Authors: Kshitij Jagtap, R Naveen, Jessica Day, Parikshit Sen, Binit Vaidya, Arvind Nune, Elena Nikiphorou, Ai Lyn Tan, Vishwesh Agarwal, Sreoshy Saha, Samuel Katsuyuki Shinjo, Nelly Ziade, Mrudula Joshi, Tsvetelina Velikova, Marcin Milchert, Ioannis Parodis, Abraham Edgar Gracia-Ramos, Lorenzo Cavagna, Masataka Kuwana, Johannes Knitza, Ashima Makol, Aarat Patel, John D Pauling, Chris Wincup, Bhupen Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Iris J Colunga-Pedraza, Javier Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada Katchamart, Phonpen Akawatcharangura Goo, Russka Shumnalieva, Yi-Ming Chen, Leonardo Santos Hoff, Lina El Kibbi, Hussein Halabi, Syahrul Sazliyana Shaharir, A T M Tanveer Hasan, Dzifa Dey, Carlos Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, James B Lilleker, Babur Salim, Tamer Gheita, Tulika Chatterjee, Miguel A Saavedra, Oliver Distler, COVAD Study Group, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta, Zoltán Griger, Sinan Kardes, Laura Andreoli, Daniele Lini, Karen Schreiber, Melinda Nagy Vince, Yogesh Preet Singh, Rajiv Ranjan, Avinash Jain, Sapan C Pandya, Rakesh Kumar Pilania, Aman Sharma, Manesh Manoj M, Vikas Gupta, Chengappa G Kavadichanda, Pradeepta Sekhar Patro, Sajal Ajmani, Sanat Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha Shenoy, Ajay Asranna, Keerthi Talari Bommakanti, Anuj Shukla, Arunkumar R. Pande, Kunal Chandwar, Akanksha Ghodke, Hiya Boro, Zoha Zahid Fazal, Döndü Üsküdar Cansu, Reşit Yıldırım, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca Sambataro, Atzeni Fabiola, Marcello Govoni, Simone Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico Fusaro, Marco Sebastiani, Luca Quartuccio, Franco Franceschini, Pier Paolo Sainaghi, Giovanni Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo Venerito, Silvia Grignaschi, Alessandro Giollo, Alessia Alluno, Florenzo Ioannone, Marco Fornaro, Lisa S Traboco, Suryo Anggoro Kusumo Wibowo, Jesús Loarce-Martos, Sergio Prieto-González, Raquel Aranega Gonzalez, Akira Yoshida, Ran Nakashima, Shinji Sato, Naoki Kimura, Yuko Kaneko, Takahisa Gono, Stylianos Tomaras, Fabian Nikolai Proft, Marie-Therese Holzer, Margarita Aleksandrovna Gromova, Or Aharonov, Ihsane Hmamouchi, Imane El bouchti, Zineb Baba, Margherita Giannini, François Maurier, Julien Campagne, Alain Meyer, Daman Langguth, Vidya Limaye, Merrilee Needham, Nilesh Srivastav, Marie Hudson, Océane Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro Arbeláez, Javier Cajas, José António Pereira Silva, João Eurico Fonseca, Olena Zimba, Doskaliuk Bohdana, Uyi Ima-Edomwonyi, Ibukunoluwa Dedeke, Emorinken Airenakho, Nwankwo Henry Madu, Abubakar Yerima, Hakeem Olaosebikan, Becky A., Oruma Devi Koussougbo, Elisa Palalane, Ho So, Manuel Francisco Ugarte-Gil, Lyn Chinchay, José Proaño Bernaola, Victorio Pimentel, Hanan Mohammed Fathi, Reem Hamdy A Mohammed, Ghita Harifi, Yurilís Fuentes-Silva, Karoll Cabriza, Jonathan Losanto, Nelly Colaman, Antonio Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Lilith Stange Nunez, Cristian Vergara M, Jossiell Then Báez, Hugo Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo Chávez, Andrea Bran Ordóñez, Sandra Argueta, Gil Alberto Reyes Llerena, Radames Sierra-Zorita, Dina Arrieta, Eduardo Romero Hidalgo, Ricardo Saenz, Idania Escalante M, Wendy Calapaqui, Ivonne Quezada, and Gabriela Arredondo.
Contributors: Jagtap, Kshitij, Naveen, R, Day, Jessica, Sen, Parikshit, Vaidya, Binit, Nune, Arvind, Nikiphorou, Elena, Tan, Ai Lyn, Agarwal, Vishwesh, Saha, Sreoshy, Shinjo, Samuel Katsuyuki, Ziade, Nelly, Joshi, Mrudula, Velikova, Tsvetelina, Milchert, Marcin, Parodis, Ioanni, Edgar Gracia-Ramos, Abraham, Cavagna, Lorenzo, Kuwana, Masataka, Knitza, Johanne, Makol, Ashima, Patel, Aarat, Pauling, John D, Wincup, Chri, Barman, Bhupen, Zamora Tehozol, Erick Adrian, Rojas Serrano, Jorge, García-De La Torre, Ignacio, Colunga-Pedraza, Iris J, Merayo-Chalico, Javier, Chibuzo, Okwara Celestine, Katchamart, Wanruchada, Goo, Phonpen Akawatcharangura, Shumnalieva, Russka, Chen, Yi-Ming, Hoff, Leonardo Santo, El Kibbi, Lina, Halabi, Hussein, Sazliyana Shaharir, Syahrul, Hasan, A T M Tanveer, Dey, Dzifa, Gutiérrez, Carlos Enrique Toro, Caballero-Uribe, Carlo Vinicio, Lilleker, James B, Salim, Babur, Gheita, Tamer, Chatterjee, Tulika, Saavedra, Miguel A, Distler, Oliver, Null, Null, Griger, Zoltán, Kardes, Sinan, Andreoli, Laura, Lini, Daniele, Schreiber, Karen, Vince, Melinda Nagy, Singh, Yogesh Preet, Ranjan, Rajiv, Jain, Avinash, Pandya, Sapan C, Pilania, Rakesh Kumar, Sharma, Aman, Manesh Manoj, M, Gupta, Vika, Kavadichanda, Chengappa G, Patro, Pradeepta Sekhar, Ajmani, Sajal, Phatak, Sanat, Goswami, Rudra Prosad, Chowdhury, Abhra Chandra, Mathew, Ashish Jacob, Shenoy, Padnamabha, Asranna, Ajay, Bommakanti, Keerthi Talari, Shukla, Anuj, Pande, Arunkumar R, Chandwar, Kunal, Ghodke, Akanksha, Boro, Hiya, Fazal, Zoha Zahid, Cansu, Döndü Üsküdar, Yıldırım, Reşit, Gasparyan, Armen Yuri, Del Papa, Nicoletta, Sambataro, Gianluca, Fabiola, Atzeni, Govoni, Marcello, Parisi, Simone, Bocci, Elena Bartoloni, Sebastiani, Gian Domenico, Fusaro, Enrico, Sebastiani, Marco, Quartuccio, Luca, Franceschini, Franco, Sainaghi, Pier Paolo, Orsolini, Giovanni, De Angelis, Rossella, Danielli, Maria Giovanna, Venerito, Vincenzo, Grignaschi, Silvia
Source: 2023, 'Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period-a cross-sequential study based on COVAD surveys', Rheumatology, vol. 62, no. 12, pp. 3838-3848. https://doi.org/10.1093/rheumatology/kead144
COVAD Study Group 2023, 'Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period-A Cross-sequential study based on COVAD surveys', Rheumatology. https://doi.org/10.1093/rheumatology/kead144
Publisher Information: Oxford University Press (OUP), 2023.
Publication Year: 2023
Subject Terms: COVID-19 Vaccines, autoimmunity, Vaccination, vaccination hesitancy, COVID-19, flares, vaccination, Autoimmune Diseases, 3. Good health, rheumatic, Autoimmune Diseases/epidemiology, Rheumatic Diseases, vaccine hesitancy, Humans, Rheumatic Diseases/epidemiology, flare, Covid-19, COVID-19/epidemiology
Description: Objective Flares of autoimmune rheumatic diseases (AIRDs) following COVID-19 vaccination are a particular concern in vaccine-hesitant individuals. Therefore, we investigated the incidence, predictors and patterns of flares following vaccination in individuals living with AIRDs, using global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surveys. Methods The COVAD surveys were used to extract data on flare demographics, comorbidities, COVID-19 history, and vaccination details for patients with AIRDs. Flares following vaccination were identified as patient-reported (a), increased immunosuppression (b), clinical exacerbations (c) and worsening of PROMIS scores (d). We studied flare characteristics and used regression models to differentiate flares among various AIRDs. Results Of 15 165 total responses, the incidence of flares in 3453 patients with AIRDs was 11.3%, 14.8%, 9.5% and 26.7% by definitions a–d, respectively. There was moderate agreement between patient-reported and immunosuppression-defined flares (K = 0.403, P = 0.022). Arthritis (61.6%) and fatigue (58.8%) were the most commonly reported symptoms. Self-reported flares were associated with higher comorbidities (P = 0.013), mental health disorders (MHDs) (P In regression analysis, the presence of AIDm [odds ratio (OR) = 1.4; 95% CI: 1.1, 1.7; P = 0.003), or a MHD (OR = 1.7; 95% CI: 1.1, 2.6; P = 0.007), or being a Moderna vaccine recipient (OR = 1.5; 95% CI: 1.09, 2.2; P = 0.014) were predictors of flares. Use of MMF (OR = 0.5; 95% CI: 0.3, 0.8; P = 0.009) and glucocorticoids (OR = 0.6; 95% CI: 0.5, 0.8; P = 0.003) were protective. A higher frequency of patients with AIRDs reported overall active disease post-vaccination compared with before vaccination (OR = 1.3; 95% CI: 1.1, 1.5; P Conclusion Flares occur in nearly 1 in 10 individuals with AIRDs after COVID vaccination; people with comorbidities (especially AIDm), MHDs and those receiving the Moderna vaccine are particularly vulnerable. Future avenues include exploring flare profiles and optimizing vaccine strategies for this group.
Document Type: Article
File Description: application/vnd.openxmlformats-officedocument.wordprocessingml.document
Language: English
ISSN: 1462-0332
1462-0324
DOI: 10.1093/rheumatology/kead144
Access URL: https://pubmed.ncbi.nlm.nih.gov/36961331
https://research.manchester.ac.uk/en/publications/1de9d800-c27e-48f4-ad3d-ab27f78d2e22
https://doi.org/10.1093/rheumatology/kead144
https://kclpure.kcl.ac.uk/portal/en/publications/36b106b4-8850-4751-b9c4-91769ca1078e
https://hdl.handle.net/11379/600006
https://doi.org/10.1093/rheumatology/kead144
https://pure.manchester.ac.uk/ws/files/256277474/Flares_in_AIRD.docx
https://www.mendeley.com/catalogue/f7d6d1e4-0a73-3365-96bf-cca4ab4ad94e/
https://research.manchester.ac.uk/en/publications/1de9d800-c27e-48f4-ad3d-ab27f78d2e22
https://doi.org/10.1093/rheumatology/kead144
Rights: OUP Standard Publication Reuse
Accession Number: edsair.doi.dedup.....06306e27cdfb59896d68babc8871031b
Database: OpenAIRE
Description
Abstract:Objective Flares of autoimmune rheumatic diseases (AIRDs) following COVID-19 vaccination are a particular concern in vaccine-hesitant individuals. Therefore, we investigated the incidence, predictors and patterns of flares following vaccination in individuals living with AIRDs, using global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surveys. Methods The COVAD surveys were used to extract data on flare demographics, comorbidities, COVID-19 history, and vaccination details for patients with AIRDs. Flares following vaccination were identified as patient-reported (a), increased immunosuppression (b), clinical exacerbations (c) and worsening of PROMIS scores (d). We studied flare characteristics and used regression models to differentiate flares among various AIRDs. Results Of 15 165 total responses, the incidence of flares in 3453 patients with AIRDs was 11.3%, 14.8%, 9.5% and 26.7% by definitions a–d, respectively. There was moderate agreement between patient-reported and immunosuppression-defined flares (K = 0.403, P = 0.022). Arthritis (61.6%) and fatigue (58.8%) were the most commonly reported symptoms. Self-reported flares were associated with higher comorbidities (P = 0.013), mental health disorders (MHDs) (P In regression analysis, the presence of AIDm [odds ratio (OR) = 1.4; 95% CI: 1.1, 1.7; P = 0.003), or a MHD (OR = 1.7; 95% CI: 1.1, 2.6; P = 0.007), or being a Moderna vaccine recipient (OR = 1.5; 95% CI: 1.09, 2.2; P = 0.014) were predictors of flares. Use of MMF (OR = 0.5; 95% CI: 0.3, 0.8; P = 0.009) and glucocorticoids (OR = 0.6; 95% CI: 0.5, 0.8; P = 0.003) were protective. A higher frequency of patients with AIRDs reported overall active disease post-vaccination compared with before vaccination (OR = 1.3; 95% CI: 1.1, 1.5; P Conclusion Flares occur in nearly 1 in 10 individuals with AIRDs after COVID vaccination; people with comorbidities (especially AIDm), MHDs and those receiving the Moderna vaccine are particularly vulnerable. Future avenues include exploring flare profiles and optimizing vaccine strategies for this group.
ISSN:14620332
14620324
DOI:10.1093/rheumatology/kead144