Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study
Abstract Objective To determine prevalence and factors associated with flares post Coronavirus disease 2019 (COVID-19) mRNA vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA). Methods A retrospective multi-centre study was conducted (January...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Advances in Rheumatology |
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| Online Access: | https://doi.org/10.1186/s42358-023-00316-0 |
| _version_ | 1797752583070154752 |
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| author | Warren Fong Ting Hui Woon Li-Ching Chew Andrea Low Annie Law Yih Jia Poh Siaw Ing Yeo Ying Ying Leung Margaret Ma Amelia Santosa Kok Ooi Kong Chuanhui Xu Gim Gee Teng Anselm Mak Sen Hee Tay Tyng Yu Chuah Nur Emillia Roslan Stanley Angkodjojo Kee Fong Phang Melonie Sriranganathan Teck Choon Tan Peter Cheung Manjari Lahiri |
| author_facet | Warren Fong Ting Hui Woon Li-Ching Chew Andrea Low Annie Law Yih Jia Poh Siaw Ing Yeo Ying Ying Leung Margaret Ma Amelia Santosa Kok Ooi Kong Chuanhui Xu Gim Gee Teng Anselm Mak Sen Hee Tay Tyng Yu Chuah Nur Emillia Roslan Stanley Angkodjojo Kee Fong Phang Melonie Sriranganathan Teck Choon Tan Peter Cheung Manjari Lahiri |
| author_sort | Warren Fong |
| collection | DOAJ |
| description | Abstract Objective To determine prevalence and factors associated with flares post Coronavirus disease 2019 (COVID-19) mRNA vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA). Methods A retrospective multi-centre study was conducted (January 2021 to February 2022). Data were collected during index visit, defined as first post-vaccine visit in which the patient had a physician-defined flare, or if at least 3 months had elapsed since first vaccine dose, whichever came first. Factors associated with flares were identified using mixed effects Cox regression and expressed as hazard ratio (HR) and 95% confidence interval (CI). Results Total of 2377 patients were included (1563 RA, 415 PsA and 399 SpA). Among patients with RA, PsA and SpA, 21.3%, 24.1% and 21.8% experienced a flare respectively. Of those who experienced a flare, only 10.2%, 11.0% and 14.9% were severe in patients with RA, PsA and SpA respectively. Patients with low or moderate/high disease were more likely to flare compared to those in remission in patients with RA only (HR: 1.68, 95% CI 1.22–2.31; HR: 2.28, 95% CI 1.50–3.48, respectively). Receiving the Moderna vaccine was associated with a higher HR of flare compared to the Pfizer vaccine in patients with PsA only (HR: 2.21, 95% CI 1.20–4.08). Patients who had two vaccine doses were found to be less likely to flare (HR: 0.08, 95% CI 0.06–0.10). HRs of flares were not significantly different among RA, PsA and SpA. Conclusion About one-fifth of patients experienced a disease flare post COVID-19 mRNA vaccination, but most flares were non-severe. Patients with active disease prior to vaccination should be monitored closely for disease flares, especially in patients with RA. |
| first_indexed | 2024-03-12T17:06:29Z |
| format | Article |
| id | doaj.art-ce3fe011dc1d4083aff5491f80a2892b |
| institution | Directory Open Access Journal |
| issn | 2523-3106 |
| language | English |
| last_indexed | 2024-03-12T17:06:29Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Rheumatology |
| spelling | doaj.art-ce3fe011dc1d4083aff5491f80a2892b2023-08-06T11:27:57ZengBMCAdvances in Rheumatology2523-31062023-08-016311910.1186/s42358-023-00316-0Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort studyWarren Fong0Ting Hui Woon1Li-Ching Chew2Andrea Low3Annie Law4Yih Jia Poh5Siaw Ing Yeo6Ying Ying Leung7Margaret Ma8Amelia Santosa9Kok Ooi Kong10Chuanhui Xu11Gim Gee Teng12Anselm Mak13Sen Hee Tay14Tyng Yu Chuah15Nur Emillia Roslan16Stanley Angkodjojo17Kee Fong Phang18Melonie Sriranganathan19Teck Choon Tan20Peter Cheung21Manjari Lahiri22Department of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Rheumatology and Immunology, Singapore General HospitalDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeRheumatology, Tan Tock Seng HospitalRheumatology, Tan Tock Seng HospitalDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeRheumatology, Sengkang General HospitalRheumatology, Sengkang General HospitalRheumatology, Sengkang General HospitalDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeRheumatology, Changi General HospitalRheumatology, Khoo Teck Puat HospitalDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of SingaporeAbstract Objective To determine prevalence and factors associated with flares post Coronavirus disease 2019 (COVID-19) mRNA vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA). Methods A retrospective multi-centre study was conducted (January 2021 to February 2022). Data were collected during index visit, defined as first post-vaccine visit in which the patient had a physician-defined flare, or if at least 3 months had elapsed since first vaccine dose, whichever came first. Factors associated with flares were identified using mixed effects Cox regression and expressed as hazard ratio (HR) and 95% confidence interval (CI). Results Total of 2377 patients were included (1563 RA, 415 PsA and 399 SpA). Among patients with RA, PsA and SpA, 21.3%, 24.1% and 21.8% experienced a flare respectively. Of those who experienced a flare, only 10.2%, 11.0% and 14.9% were severe in patients with RA, PsA and SpA respectively. Patients with low or moderate/high disease were more likely to flare compared to those in remission in patients with RA only (HR: 1.68, 95% CI 1.22–2.31; HR: 2.28, 95% CI 1.50–3.48, respectively). Receiving the Moderna vaccine was associated with a higher HR of flare compared to the Pfizer vaccine in patients with PsA only (HR: 2.21, 95% CI 1.20–4.08). Patients who had two vaccine doses were found to be less likely to flare (HR: 0.08, 95% CI 0.06–0.10). HRs of flares were not significantly different among RA, PsA and SpA. Conclusion About one-fifth of patients experienced a disease flare post COVID-19 mRNA vaccination, but most flares were non-severe. Patients with active disease prior to vaccination should be monitored closely for disease flares, especially in patients with RA.https://doi.org/10.1186/s42358-023-00316-0COVID-19Autoimmune inflammatory rheumatic diseasesmRNA vaccineFlares |
| spellingShingle | Warren Fong Ting Hui Woon Li-Ching Chew Andrea Low Annie Law Yih Jia Poh Siaw Ing Yeo Ying Ying Leung Margaret Ma Amelia Santosa Kok Ooi Kong Chuanhui Xu Gim Gee Teng Anselm Mak Sen Hee Tay Tyng Yu Chuah Nur Emillia Roslan Stanley Angkodjojo Kee Fong Phang Melonie Sriranganathan Teck Choon Tan Peter Cheung Manjari Lahiri Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study Advances in Rheumatology COVID-19 Autoimmune inflammatory rheumatic diseases mRNA vaccine Flares |
| title | Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study |
| title_full | Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study |
| title_fullStr | Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study |
| title_full_unstemmed | Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study |
| title_short | Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study |
| title_sort | prevalence and factors associated with flares following covid 19 mrna vaccination in patients with rheumatoid arthritis psoriatic arthritis and spondyloarthritis a national cohort study |
| topic | COVID-19 Autoimmune inflammatory rheumatic diseases mRNA vaccine Flares |
| url | https://doi.org/10.1186/s42358-023-00316-0 |
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