| Title: | Factors associated with disease flare following SARS-CoV-2 vaccination in people with inflammatory rheumatic and musculoskeletal diseases : results from the physician-reported EULAR Coronavirus Vaccine (COVAX) Registry |
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| Authors: | ID Farisogullari, Bayram (Author)
ID Lawson-Tovey, Saskia (Author)
ID Hyrich, Kimme L (Author)
ID Gossec, Laure (Author)
ID Carmona, Loreto (Author)
ID Strangfeld, Anja (Author)
ID Frazão Mateus, Elsa (Author)
ID Schäfer, Martin (Author)
ID Rodrigues, Ana Maria (Author)
ID Hachulla, Eric (Author)
ID Hočevar, Alojzija (Research coworker), et al. |
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| Files: |  PDF - Presentation file, download (959,17 KB)
MD5: AF94014A46AFA760D32775EE79B445D0
 URL - Source URL, visit https://ard.bmj.com/content/83/11/1584.long
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | Objectives: To investigate the frequency and factors associated with disease flare following vaccination against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal diseases (I-RMDs). Methods: Data from the European Alliance of Associations for Rheumatology Coronavirus Vaccine physician-reported registry were used. Factors associated with flare in patients with I-RMDs were investigated using multivariable logistic regression adjusted for demographic and clinical factors. Results: The study included 7336 patients with I-RMD, with 272 of 7336 (3.7%) experiencing flares and 121 of 7336 (1.6%) experiencing flares requiring starting a new medication or increasing the dosage of an existing medication. Factors independently associated with increased odds of flare were: female sex (OR=1.40, 95% CI=1.05 to 1.87), active disease at the time of vaccination (low disease activity (LDA), OR=1.45, 95% CI=1.08 to 1.94; moderate/high disease activity (M/HDA), OR=1.37, 95% CI=0.97 to 1.95; vs remission), and cessation/reduction of antirheumatic medication before or after vaccination (OR=4.76, 95% CI=3.44 to 6.58); factors associated with decreased odds of flare were: higher age (OR=0.90, 95% CI=0.83 to 0.98), non-Pfizer/AstraZeneca/Moderna vaccines (OR=0.10, 95% CI=0.01 to 0.74; vs Pfizer), and exposure to methotrexate (OR=0.57, 95% CI=0.37 to 0.90), tumour necrosis factor inhibitors (OR=0.55, 95% CI=0.36 to 0.85) or rituximab (OR=0.27, 95% CI=0.11 to 0.66), versus no antirheumatic treatment. In a multivariable model using new medication or dosage increase due to flare as the dependent variable, only the following independent associations were observed: active disease (LDA, OR=1.47, 95% CI=0.94 to 2.29; M/HDA, OR=3.08, 95% CI=1.91 to 4.97; vs remission), cessation/reduction of antirheumatic medication before or after vaccination (OR=2.24, 95% CI=1.33 to 3.78), and exposure to methotrexate (OR=0.48, 95% CI=0.26 to 0.89) or rituximab (OR=0.10, 95% CI=0.01 to 0.77), versus no antirheumatic treatment. Conclusion: I-RMD flares following SARS-CoV-2 vaccination were uncommon. Factors associated with flares were identified, namely higher disease activity and cessation/reduction of antirheumatic medications before or after vaccination. |
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| Keywords: | antirheumatic agents, autoimmune diseases, Covid-19, epidemiology, vaccination |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2024 |
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| Number of pages: | str. 1584-1595 |
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| Numbering: | Vol. 83, iss. 11 |
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| PID: | 20.500.12556/DiRROS-27831  |
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| UDC: | 616-002 |
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| ISSN on article: | 0003-4967 |
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| DOI: | 10.1136/ard-2024-225869 |
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| COBISS.SI-ID: | 225899779 |
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| Note: |
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| Publication date in DiRROS: | 26.02.2026 |
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| Views: | 227 |
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| Downloads: | 125 |
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