The following is a summary of “Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study,” published in the August 2023 issue of Rheumatology by Fong et al.
Researchers started a retrospective study to investigate the prevalence and factors associated with Coronavirus disease 2019 (COVID-19) vaccine flares in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondyloarthritis (SpA).
They conducted a retrospective multi-center study from January 2021 to February 2022. Data collection occurred during the index visit, defined as the patient’s first post-vaccine visit with a physician-defined flare or if at least three months had elapsed since the first vaccine dose, whichever came first. Factors linked to flares were identified using Cox regression, reported as hazard ratios (HR) with 95% CI.
The results showed 2,377 patients, including 1,563 with RA, 415 with PsA, and 399 with SpA. Flare rates were 21.3%, 24.1%, and 21.8% for RA, PsA, and SpA, respectively. Among those experiencing flares, only 10.2%, 11.0%, and 14.9% were severe for RA, PsA, and SpA. Patients with low or moderate/high disease activity in RA were likelier to experience flares than those in remission (HR: 1.68, 95% CI 1.22–2.31; HR: 2.28, 95% CI 1.50–3.48, respectively). Receiving the Moderna vaccine was linked with a higher flare risk compared to the Pfizer vaccine in PsA patients (HR: 2.21, 95% CI 1.20–4.08). Patients who received both vaccine doses were less likely to experience flares (HR: 0.08, 95% CI 0.06–0.10). The flare HRs did not significantly differ among RA, PsA, and SpA.
They concluded that one-fifth of arthritis patients experienced non-severe flares after COVID-19 vaccination, so monitor patients with active disease closely.
Source: advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-023-00316-0