Objectives: Disease flares in the post–coronavirus disease 2019 (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 minimal clinically significant improvement difference worsening of Patient-Reported Outcomes Measurement Information System (PROMIS) PROMISPF10a score. Risk factors of flares were analysed using regression models. Results: Of 15 165 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) to (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 AZA (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 IS. Asthma (OR 1.62; 95% CI 1.05, 2.50, P = 0.028) and higher pain visual analogue score (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.
Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys / R, Naveen; Sen, Parikshit; Griger, Zoltán; Day, Jessica; Joshi, Mrudula; Nune, Arvind; Nikiphorou, Elena; Saha, Sreoshy; Lyn Tan, Ai; Katsuyuki Shinjo, Samuel; Ziade, Nelly; Velikova, Tsvetelina; Milchert, Marcin; Jagtap, Kshitij; Parodis, Ioannis; Edgar Gracia-Ramos, Abraham; Cavagna, Lorenzo; Kuwana, Masataka; Knitza, Johannes; Ming Chen, Yi; Makol, Ashima; Agarwal, Vishwesh; Patel, Aarat; D Pauling, John; Wincup, Chris; Barman, Bhupen; Adrian Zamora Tehozol, Erick; Rojas Serrano, Jorge; García-De La Torre, Ignacio; J Colunga-Pedraza, Iris; Merayo-Chalico, Javier; Celestine Chibuzo, Okwara; Katchamart, Wanruchada; Akawatcharangura Goo, Phonpen; Shumnalieva, Russka; Santos Hoff, Leonardo; Lina Kibbi, El; Halabi, Hussein; Vaidya, Binit; Sazliyana Shaharir, Syahrul; M Tanveer Hasan, A T; Dey, Dzifa; Enrique Toro Gutiérrez, Carlos; Vinicio Caballero-Uribe, Carlo; B Lilleker, James; Salim, Babur; Gheita, Tamer; Chatterjee, Tulika; Distler, Oliver; A Saavedra, Miguel; Chinoy, Hector; Agarwal, Vikas; Aggarwal, Rohit; Gupta, Latika; study group, Covad; Sinan, Kardes; Laura, Andreoli; Daniele, Lini; Karen, Screiber; Nagy Vince, Melinda; Preet Singh, Yogesh; Rajiv, Ranjan; Avinash, Jain; C Pandya, Sapan; Kumar Pilania, Rakesh; Aman, Sharma; M Manesh, Manoj; Gupta, Vikas; G Kavadichanda, Chengappa; Sekhar Patro, Pradeepta; Sajal, Ajmani; Sanat, Phatak; Prosad Goswami, Rudra; Chandra Chowdhury, Abhra; Jacob Mathew, Ashish; Padnamabha, Shenoy; Ajay, Asranna; Talari Bommakanti, Keerthi; Anuj, Shukla; R Pande, Arunkumar; Kunal, Chandwar; Akanksha, Ghodke; Hiya, Boro; Zahid Fazal, Zoha; Üsküdar Cansu, Döndü; Reşit, Yıldırım; Yuri Gasparyan, Armen; Del Papa, Nicoletta; Gianluca, Sambataro; Atzeni, Fabiola; Marcello, Govoni; Simone, Parisi; Bartoloni Bocci, Elena; Domenico Sebastiani, Gian; Enrico, Fusaro; Marco, Sebastiani; Luca, Quartuccio; Franco, Franceschini; Paolo Sainaghi, Pier; Giovanni, Orsolini; DE ANGELIS, Rossella; Giovanna Danielli, Maria; Vincenzo, Venerito; Silvia, Grignaschi; Alessandro, Giollo; Alessia, Alluno; Florenzo, Ioannone; Marco, Fornaro; S Traboco, Lisa; Anggoro Kusumo Wibowo, Suryo; Loarce-Martos, Jesús; Prieto-González, Sergio; Aranega Gonzalez, Raquel; Akira, Yoshida; Ran, Nakashima; Shinji, Sato; Naoki, Kimura; Yuko, Kaneko; Takahisa, Gono; Stylianos, Tomaras; Nikolai Proft, Fabian; Marietherese, Holzer; Aleksandrovna Gromova, Margarita; Or, Aharonov; Griger, Zoltán; Ihsane, Hmamouchi; El Bouchti, Imane; Zineb, Baba; Margherita, Giannini; François, Maurier; Julien, Campagne; Alain, Meyer; Daman, Langguth; Vidya, Limaye; Merrilee, Needham; Nilesh, Srivastav; Marie, Hudson; Landon-Cardinal, Océane; Gerardo Rojas Zuleta, Wilmer; Álvaro, Arbeláez; Cajas, Javier; António Pereira Silva, José; Eurico Fonseca, João; Olena, Zimba; Doskaliuk, Bohdana; Ima-Edomwonyi, Uyi; Ibukunoluwa, Dedeke; Emorinken, Airenakho; Henry Madu, Nwankwo; Abubakar, Yerima; Hakeem, Olaosebikan; A, Becky; Devi Koussougbo, Oruma; Elisa, Palalane; Ho, So; Francisco Ugarte-Gil, Manuel; Chinchay, Lyn; Proaño Bernaola, José; Victorio, Pimentel; Mohammed Fathi, Hanan; A Mohammed, Reem Hamdy; Ghita, Harifi; Fuentes-Silva, Yurilís; Karoll, Cabriza; Jonathan, Losanto; Colaman, Nelly; Cachafeiro-Vilar, Antonio; Guerra Bautista, Generoso; Julio Giraldo Ho, Enrique; Raúl, González; Stange Nunez, Lilith; M Cristian, Vergara; Then Báez, Jossiell; Hugo, Alonzo; Benito Santiago Pastelin, Carlos; Rodrigo García, Salinas; Quiñónez Obiols, Alejandro; Nilmo, Chávez; Bran Ordóñez, Andrea; Alberto Reyes Llerena, Gil; Sierra-Zorita, Radames; Dina, Arrieta; Romero Hidalgo, Eduardo; Ricardo, Saenz; M Idania, Escalante; Wendy, Calapaqui; Ivonne, Quezada; Arredondo, Gabriela. - In: RHEUMATOLOGY. - ISSN 1462-0324. - 63:1(2024), pp. 127-139. [10.1093/rheumatology/kead180]
Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Rossella De AngelisMembro del Collaboration Group
;
2024-01-01
Abstract
Objectives: Disease flares in the post–coronavirus disease 2019 (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 minimal clinically significant improvement difference worsening of Patient-Reported Outcomes Measurement Information System (PROMIS) PROMISPF10a score. Risk factors of flares were analysed using regression models. Results: Of 15 165 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) to (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 AZA (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 IS. Asthma (OR 1.62; 95% CI 1.05, 2.50, P = 0.028) and higher pain visual analogue score (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.| File | Dimensione | Formato | |
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