For patients with rheumatic and musculoskeletal diseases (RMD), flare is uncommon following SARS-CoV-2 mRNA vaccination, according to a study published in Arthritis & Rheumatology. Researchers examined disease flare and post-vaccination reactions in 1,377 patients with RMD following two-dose SARS-CoV-2 mRNA vaccination. Questionnaires were completed detailing local and systemic reactions experienced within 7 days of each vaccine dose, and RMD flare was assessed within 1 month after the second dose. The study team found that 11% reported flare that necessitated treatment, but there were no reports of severe flares. There were associations seen for flare with prior SARS-CoV-2 infection, flare in the 6 months preceding vaccination, and use of combination immunomodulatory therapy (incidence rate ratios, 2.09, 2.36, and 1.95, respectively). Injection site pain and fatigue were the most commonly reported local and systemic reactions; reactogenicity increased after the second dose, especially for systemic reactions. There were no reports of allergic reactions or SARS-CoV-2 diagnoses.

Diagnosis of Inflammatory Arthritis Tied to Impaired Male Fertility

Inflammatory arthritis (IA) may impair male fertility, and men diagnosed before and during the peak of reproductive age have a lower fertility rate and higher rate of childlessness, according to a study published in Annals of the Rheumatic Diseases. Investigators performed a multicenter cross-sectional study to examine the impact of IA on male fertility outcomes. Men with IA aged 40 or older who indicated that their family size was complete were invited to participate and completed a questionnaire including demographic, medical, and fertility-related questions. Data were included for 628 men diagnosed with IA. Men diagnosed at age 30 or younger had a significantly lower mean number of children than those diagnosed between ages 31 and 40 and 41 or older (1.32 vs 1.60 and 1.88, respectively). Compared with men diagnosed at age 41 or older, statistically significantly higher percentages of men diagnosed at 30 or younger and at 31-40 were involuntarily childless (3.98% vs 12.03% and 10.34%, respectively) and reported having received medical evaluations for fertility problems (11.36% vs 20.61% and 20.69%, respectively). “The diagnosis of IA before or during the peak of reproductive age can result in impaired male fertility,” the authors wrote. “Rheumatologists should be aware of this novel association and approach their patients accordingly.”