Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Articolo
Data di Pubblicazione:
2024
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.
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.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
COVID-19 vaccines; disease exacerbation; idiopathic inflammatory myopathies; patient-reported outcomes.
Elenco autori:
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; Akarawatcharangura Goo, Phonpen; Shumnalieva, Russka; Santos Hoff, Leonardo; El Kibbi, Lina; Halabi, Hussein; Vaidya, Binit; Sazliyana Shaharir, Syahrul; M Tanveer Hasan, A T; Dey, Dzifa; Enrique Toro Gutiérrez, Carlos; V 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 authors: Sinan Kardes, Covad; Andreoli, Laura; Lini, Daniele; Schreiber, Karen; Nagy Vince, Melinda; Preet Singh, Yogesh; Ranjan, Rajiv; Jain, Avinash; Pandya, Sapan C.; Kumar Pilania, Rakesh; Sharma, Aman; Manesh Manoj, M.; Gupta, Vikas; Kavadichanda, Chengappa G.; Sekhar Patro, Pradeepta; Ajmani, Sajal; Phatak, Sanat; Prosad Goswami, Rudra; Chandra Chowdhury, Abhra; Jacob Mathew, Ashish; Shenoy, Padnamabha; Asranna, Ajay; Talari Bommakanti, Keerthi; Shukla, Anuj; Pande, Arunkumar R.; Chandwar, Kunal; Ghodke, Akanksha; Boro, Hiya; Zahid Fazal, Zoha; Üsküdar Cansu, Döndü; Yıldırım, Reşit; Yuri Gasparyan, Armen; Del Papa, Nicoletta; Sambataro, Gianluca; Fabiola, Atzeni; Govoni, Marcello; Parisi, Simone; Bartoloni Bocci, Elena; Domenico Sebastiani, Gian; Fusaro, Enrico; Sebastiani, Marco; Quartuccio, Luca; Franceschini, Franco; Paolo Sainaghi, Pier; Orsolini, Giovanni; De Angelis, Rossella; Giovanna Danielli, Maria; Venerito, Vincenzo; Grignaschi, Silvia; Giollo, Alessandro; Alluno, Alessia; Ioannone, Florenzo; Fornaro, Marco; Traboco, Lisa S.; Anggoro Kusumo Wibowo, Suryo; Loarce-Martos, Jesús; Prieto-González, Sergio; Aranega Gonzalez, Raquel; Yoshida, Akira; Nakashima, Ran; Sato, Shinji; Kimura, Naoki; Kaneko, Yuko; Gono, Takahisa; Tomaras, Stylianos; Nikolai Proft, Fabian; Holzer, Marie-Therese; Aleksandrovna Gromova, Margarita; Aharonov, Or; Griger, Zoltán; Hmamouchi, Ihsane; El Bouchti, Imane; Baba, Zineb; Giannini, Margherita; Maurier, François; Campagne, Julien; Meyer, Alain; Langguth, Daman; Limaye, Vidya; Needham, Merrilee; Srivastav, Nilesh; Hudson, Marie; Landon-Cardinal, Océane; Gerardo Rojas Zuleta, Wilmer; Arbeláez, Álvaro; Cajas, Javier; António Pereira Silva, José; Eurico Fonseca, João; Zimba, Olena; Bohdana, Doskaliuk; Ima-Edomwonyi, Uyi; Dedeke, Ibukunoluwa; Airenakho, Emorinken; Henry Madu, Nwankwo; Yerima, Abubakar; Olaosebikan, Hakeem; A., Becky; Devi Koussougbo, Oruma; Palalane, Elisa; So, Ho; Francisco Ugarte-Gil, Manuel; Chinchay, Lyn; Proaño Bernaola, José; Pimentel, Victorio; Mohammed Fathi, Hanan; Mohammed, Reem Hamdy A.; Harifi, Ghita; Fuentes-Silva, Yurilís; Cabriza, Karoll; Losanto, Jonathan; Colaman, Nelly; Cachafeiro-Vilar, Antonio; Guerra Bautista, Generoso; Julio Giraldo Ho, Enrique; González, Raúl; Stange Nunez, Lilith; Cristian Vergara, M.; Then Báez, Jossiell; Alonzo, Hugo; Benito Santiago Pastelin, Carlos; García Salinas, Rodrigo; Quiñónez Obiols, Alejandro; Chávez, Nilmo; Bran Ordóñez, Andrea; Alberto Reyes Llerena, Gil; Sierra-Zorita, Radames; Arrieta, Dina; Romero Hidalgo, Eduardo; Saenz, Ricardo; Idania Escalante, M.; Calapaqui, Wendy; Quezada, Ivonne; Arredondo., Gabriela
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