Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Issued Date
2024-01-01
Resource Type
ISSN
14620324
eISSN
14620332
Scopus ID
2-s2.0-85180733005
Pubmed ID
37084267
Journal Title
Rheumatology (United Kingdom)
Volume
63
Issue
1
Start Page
127
End Page
139
Rights Holder(s)
SCOPUS
Bibliographic Citation
Rheumatology (United Kingdom) Vol.63 No.1 (2024) , 127-139
Suggested Citation
Naveen R., Sen P., Griger Z., Day J., Joshi M., Nune A., Nikiphorou E., Saha S., Tan A.L., Shinjo S.K., Ziade N., Velikova T., Milchert M., Jagtap K., Parodis I., Gracia-Ramos A.E., Cavagna L., Kuwana M., Knitza J., Chen Y.M., Makol A., Agarwal V., Patel A., Pauling J.D., Wincup C., Barman B., Zamora Tehozol E.A., Rojas Serrano J., García-De La Torre I., Colunga-Pedraza I.J., Merayo-Chalico J., Chibuzo O.C., Katchamart W., Akarawatcharangura Goo P., Shumnalieva R., Hoff L.S., El Kibbi L., Halabi H., Vaidya B., Shaharir S.S., Hasan A.T.M.T., Dey D., Toro Gutiérrez C.E., Caballero-Uribe C.V., Lilleker J.B., Salim B., Gheita T., Chatterjee T., Distler O., Saavedra M.A., Chinoy H., Agarwal V., Aggarwal R., Gupta L., Kardes S., Andreoli L., Lini D., Screiber K., Vince M.N., Singh Y.P., Ranjan R., Jain A., Pandya S.C., Pilania R.K., Sharma A., Manesh Manoj M., Gupta V., Kavadichanda C.G., Patro P.S., Ajmani S., Phatak S., Goswami R.P., Chowdhury A.C., Mathew A.J., Shenoy P., Asranna A., Bommakanti K.T., Shukla A., Pande A.R., Chandwar K., Ghodke A., Boro H., Fazal Z.Z., Cansu D.Ü., Ylldlrlm R., Gasparyan A.Y., Del Papa N., Sambataro G., Fabiola A., Govoni M., Parisi S., Bocci E.B., Sebastiani G.D., Fusaro E., Sebastiani M., Quartuccio L., Franceschini F., Sainaghi P.P., Orsolini G., De Angelis R. Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys. Rheumatology (United Kingdom) Vol.63 No.1 (2024) , 127-139. 139. doi:10.1093/rheumatology/kead180 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95916
Title
Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Author(s)
Naveen R.
Sen P.
Griger Z.
Day J.
Joshi M.
Nune A.
Nikiphorou E.
Saha S.
Tan A.L.
Shinjo S.K.
Ziade N.
Velikova T.
Milchert M.
Jagtap K.
Parodis I.
Gracia-Ramos A.E.
Cavagna L.
Kuwana M.
Knitza J.
Chen Y.M.
Makol A.
Agarwal V.
Patel A.
Pauling J.D.
Wincup C.
Barman B.
Zamora Tehozol E.A.
Rojas Serrano J.
García-De La Torre I.
Colunga-Pedraza I.J.
Merayo-Chalico J.
Chibuzo O.C.
Katchamart W.
Akarawatcharangura Goo P.
Shumnalieva R.
Hoff L.S.
El Kibbi L.
Halabi H.
Vaidya B.
Shaharir S.S.
Hasan A.T.M.T.
Dey D.
Toro Gutiérrez C.E.
Caballero-Uribe C.V.
Lilleker J.B.
Salim B.
Gheita T.
Chatterjee T.
Distler O.
Saavedra M.A.
Chinoy H.
Agarwal V.
Aggarwal R.
Gupta L.
Kardes S.
Andreoli L.
Lini D.
Screiber K.
Vince M.N.
Singh Y.P.
Ranjan R.
Jain A.
Pandya S.C.
Pilania R.K.
Sharma A.
Manesh Manoj M.
Gupta V.
Kavadichanda C.G.
Patro P.S.
Ajmani S.
Phatak S.
Goswami R.P.
Chowdhury A.C.
Mathew A.J.
Shenoy P.
Asranna A.
Bommakanti K.T.
Shukla A.
Pande A.R.
Chandwar K.
Ghodke A.
Boro H.
Fazal Z.Z.
Cansu D.Ü.
Ylldlrlm R.
Gasparyan A.Y.
Del Papa N.
Sambataro G.
Fabiola A.
Govoni M.
Parisi S.
Bocci E.B.
Sebastiani G.D.
Fusaro E.
Sebastiani M.
Quartuccio L.
Franceschini F.
Sainaghi P.P.
Orsolini G.
De Angelis R.
Sen P.
Griger Z.
Day J.
Joshi M.
Nune A.
Nikiphorou E.
Saha S.
Tan A.L.
Shinjo S.K.
Ziade N.
Velikova T.
Milchert M.
Jagtap K.
Parodis I.
Gracia-Ramos A.E.
Cavagna L.
Kuwana M.
Knitza J.
Chen Y.M.
Makol A.
Agarwal V.
Patel A.
Pauling J.D.
Wincup C.
Barman B.
Zamora Tehozol E.A.
Rojas Serrano J.
García-De La Torre I.
Colunga-Pedraza I.J.
Merayo-Chalico J.
Chibuzo O.C.
Katchamart W.
Akarawatcharangura Goo P.
Shumnalieva R.
Hoff L.S.
El Kibbi L.
Halabi H.
Vaidya B.
Shaharir S.S.
Hasan A.T.M.T.
Dey D.
Toro Gutiérrez C.E.
Caballero-Uribe C.V.
Lilleker J.B.
Salim B.
Gheita T.
Chatterjee T.
Distler O.
Saavedra M.A.
Chinoy H.
Agarwal V.
Aggarwal R.
Gupta L.
Kardes S.
Andreoli L.
Lini D.
Screiber K.
Vince M.N.
Singh Y.P.
Ranjan R.
Jain A.
Pandya S.C.
Pilania R.K.
Sharma A.
Manesh Manoj M.
Gupta V.
Kavadichanda C.G.
Patro P.S.
Ajmani S.
Phatak S.
Goswami R.P.
Chowdhury A.C.
Mathew A.J.
Shenoy P.
Asranna A.
Bommakanti K.T.
Shukla A.
Pande A.R.
Chandwar K.
Ghodke A.
Boro H.
Fazal Z.Z.
Cansu D.Ü.
Ylldlrlm R.
Gasparyan A.Y.
Del Papa N.
Sambataro G.
Fabiola A.
Govoni M.
Parisi S.
Bocci E.B.
Sebastiani G.D.
Fusaro E.
Sebastiani M.
Quartuccio L.
Franceschini F.
Sainaghi P.P.
Orsolini G.
De Angelis R.
Author's Affiliation
Faculty of Medicine and Health
Siriraj Hospital
UCL Division of Medicine
Graduate School of Medicine
Faculty of Biology, Medicine and Health
Bristol Medical School
NIHR Leeds Biomedical Research Centre
Southport and Ormskirk Hospital NHS Trust
Manchester University NHS Foundation Trust
Általános Orvostudományi Kar
Pontificia Universidad Javeriana, Cali
Seth GS Medical College and KEM Hospital
Fauji Foundation Hospital
Hôtel-Dieu de France Hospital
Université Saint-Joseph de Beyrouth
Universidad del Norte
Ministry of Health and Family Welfare
University of Virginia School of Medicine
Sveti Ivan Rilski hospital
Universitätsklinikum Erlangen
Universidade Potiguar
North Bristol NHS Trust
Walter and Eliza Hall Institute of Medical Research
University of Melbourne
University of Nigeria
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Faculty of Medicine
University of Leeds, School of Medicine
University College London
Mymensingh Medical College
King's College Hospital
Sofia University St. Kliment Ohridski
UniversitatsSpital Zurich
Karolinska Universitetssjukhuset
UMAE Hospital de Especialidades Centro Medico Nacional Siglo XXI
Pomeranian Medical University in Szczecin
Hospital Universitario Dr. Jose Eleuterio Gonzalez
University of Ghana
King Faisal Specialist Hospital and Research Centre
Università degli Studi di Pavia
King's College London
Maulana Azad Medical College
Instituto Nacional de la Nutrición Salvador Zubiran
Universidad de Guadalajara
Salford Royal NHS Foundation Trust
Instituto Mexicano del Seguro Social
Instituto Nacional de Enfermedades Respiratorias
Universidade de São Paulo
Birmingham City Hospital
The Royal Wolverhampton NHS Trust
Veterans General Hospital-Taichung Taiwan
Mayo Clinic
Royal Melbourne Hospital
Salford Royal Hospital
University of Pittsburgh School of Medicine
Faculty of Medicine, UKM
University of Illinois Urbana-Champaign
Mahatma Gandhi Mission Medical College
Sassoon General Hospitals
National Center for Rheumatic Diseases
Specialized Medical Center
Enam Medical College and Hospital
Queen Savang Vadhana Memorial Hospital
Siriraj Hospital
UCL Division of Medicine
Graduate School of Medicine
Faculty of Biology, Medicine and Health
Bristol Medical School
NIHR Leeds Biomedical Research Centre
Southport and Ormskirk Hospital NHS Trust
Manchester University NHS Foundation Trust
Általános Orvostudományi Kar
Pontificia Universidad Javeriana, Cali
Seth GS Medical College and KEM Hospital
Fauji Foundation Hospital
Hôtel-Dieu de France Hospital
Université Saint-Joseph de Beyrouth
Universidad del Norte
Ministry of Health and Family Welfare
University of Virginia School of Medicine
Sveti Ivan Rilski hospital
Universitätsklinikum Erlangen
Universidade Potiguar
North Bristol NHS Trust
Walter and Eliza Hall Institute of Medical Research
University of Melbourne
University of Nigeria
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Faculty of Medicine
University of Leeds, School of Medicine
University College London
Mymensingh Medical College
King's College Hospital
Sofia University St. Kliment Ohridski
UniversitatsSpital Zurich
Karolinska Universitetssjukhuset
UMAE Hospital de Especialidades Centro Medico Nacional Siglo XXI
Pomeranian Medical University in Szczecin
Hospital Universitario Dr. Jose Eleuterio Gonzalez
University of Ghana
King Faisal Specialist Hospital and Research Centre
Università degli Studi di Pavia
King's College London
Maulana Azad Medical College
Instituto Nacional de la Nutrición Salvador Zubiran
Universidad de Guadalajara
Salford Royal NHS Foundation Trust
Instituto Mexicano del Seguro Social
Instituto Nacional de Enfermedades Respiratorias
Universidade de São Paulo
Birmingham City Hospital
The Royal Wolverhampton NHS Trust
Veterans General Hospital-Taichung Taiwan
Mayo Clinic
Royal Melbourne Hospital
Salford Royal Hospital
University of Pittsburgh School of Medicine
Faculty of Medicine, UKM
University of Illinois Urbana-Champaign
Mahatma Gandhi Mission Medical College
Sassoon General Hospitals
National Center for Rheumatic Diseases
Specialized Medical Center
Enam Medical College and Hospital
Queen Savang Vadhana Memorial Hospital
Corresponding Author(s)
Other Contributor(s)
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.