Naveen, RSen, ParikshitGriger, ZoltánDay, JessicaJoshi, MrudulaNune, ArvindNikiphorou, ElenaSaha, SreoshyTan, Ai LynShinjo, Samuel KatsuyukiZiade, NellyVelikova, TsvetelinaMilchert, MarcinJagtap, KshitijParodis, IoannisEdgar Gracia-Ramos, AbrahamCavagna, LorenzoKuwana, MasatakaKnitza, JohannesChen, Yi MingMakol, AshimaAgarwal, VishweshPatel, AaratPauling, John DWincup, ChrisBarman, BhupenZamora Tehozol, Erick AdrianSerrano, Jorge RojasGarcía-De La Torre, IgnacioColunga-Pedraza, Iris JMerayo-Chalico, JavierChibuzo, Okwara CelestineKatchamart, WanruchadaGoo, Phonpen AkawatcharanguraShumnalieva, RusskaHoff, Leonardo SantosKibbi, El LinaHalabi, HusseinVaidya, BinitShaharir, Syahrul SazliyanaHasan, A T M TanveerDey, DzifaGutiérrez, Carlos Enrique ToroCaballero-Uribe, Carlo VinicioLilleker, James BSalim, BaburGheita, TamerChatterjee, TulikaDistler, OliverSaavedra, Miguel AChinoy, HectorAgarwal, VikasAggarwal, RohitGupta, Latika2023-10-192023-10-192023-04-21Naveen 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/kead1801462-033210.1093/rheumatology/kead18037084267http://hdl.handle.net/20.500.14200/2629Objectives: 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.enRheumatologyArticle