Flares in IIMs and the timeline following COVID-19 vaccination : a combined analysis of the COVAD-1 and 2 surveys
Author
Naveen, RSen, 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
Chinoy, Hector
Agarwal, Vikas
Aggarwal, Rohit
Gupta, Latika
Affiliation
Sanjay Gandhi Postgraduate Institute of Medical Sciences; Maulana Azad Medical College; University of Debrecen; Sandwell and West Birmingham NHS Trust; et al.Publication date
2023-04-21Subject
Rheumatology
Metadata
Show full item recordAbstract
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.Citation
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; COVAD study group; Chinoy H, Agarwal V, Aggarwal R, Gupta L. Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and 2 surveys. Rheumatology (Oxford). 2023 Apr 21:kead180. doi: 10.1093/rheumatology/kead180Type
ArticlePMID
37084267Journal
RheumatologyPublisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1093/rheumatology/kead180