Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys

R. Naveen; Parikshit Sen; Zoltán Griger; Jessica Day; Mrudula Joshi; Arvind Nune; Elena Nikiphorou; Sreoshy Saha; Ai Lyn Tan; Samuel Katsuyuki Shinjo; Nelly Ziade; Tsvetelina Velikova; Marcin Milchert; Kshitij Jagtap; Ioannis Parodis; Abraham Edgar Gracia-Ramos; Lorenzo Cavagna; Masataka Kuwana; Johannes Knitza; Yi Ming Chen; Ashima Makol; Vishwesh Agarwal; Aarat Patel; John D. Pauling; Chris Wincup; Bhupen Barman; Erick Adrian Zamora Tehozol; Jorge Rojas Serrano; Ignacio García-De La Torre; Iris J. Colunga-Pedraza; Javier Merayo-Chalico; Okwara Celestine Chibuzo; Wanruchada Katchamart; Phonpen Akarawatcharangura Goo; Russka Shumnalieva; Leonardo Santos Hoff; Lina El Kibbi; Hussein Halabi; Binit Vaidya; Syahrul Sazliyana Shaharir; A. T.M.Tanveer Hasan; Dzifa Dey; Carlos Enrique Toro Gutiérrez; Carlo V. Caballero-Uribe; James B. Lilleker; Babur Salim; Tamer Gheita; Tulika Chatterjee; Oliver Distler; Miguel A. Saavedra; Hector Chinoy; Vikas Agarwal; Rohit Aggarwal; Latika Gupta; Sinan Kardes; Laura Andreoli; Daniele Lini; Karen Screiber; Melinda Nagy Vince; Yogesh Preet Singh; Rajiv Ranjan; Avinash Jain; Sapan C. Pandya; Rakesh Kumar Pilania; Aman Sharma; M. Manesh Manoj; Vikas Gupta; Chengappa G. Kavadichanda; Pradeepta Sekhar Patro; Sajal Ajmani; Sanat Phatak; Rudra Prosad Goswami; Abhra Chandra Chowdhury; Ashish Jacob Mathew; Padnamabha Shenoy; Ajay Asranna; Keerthi Talari Bommakanti; Anuj Shukla; Arunkumar R. Pande; Kunal Chandwar; Akanksha Ghodke; Hiya Boro; Zoha Zahid Fazal; Döndü Üsküdar Cansu; Reşit Ylldlrlm; Armen Yuri Gasparyan; Nicoletta Del Papa; Gianluca Sambataro; Atzeni Fabiola; Marcello Govoni; Simone Parisi; Elena Bartoloni Bocci; Gian Domenico Sebastiani; Enrico Fusaro; Marco Sebastiani; Luca Quartuccio; Franco Franceschini; Pier Paolo Sainaghi; Giovanni Orsolini; Rossella De Angelis; Maria Giovanna Danielli; Vincenzo Venerito; Silvia Grignaschi; Alessandro Giollo; Alessia Alluno; Florenzo Ioannone; Marco Fornaro; Lisa S. Traboco; Suryo Anggoro Kusumo Wibowo; Jesús Loarce-Martos; Sergio Prieto-González; Raquel Aranega Gonzalez; Akira Yoshida; Ran Nakashima; Shinji Sato; Naoki Kimura; Yuko Kaneko; Takahisa Gono; Stylianos Tomaras; Fabian Nikolai Proft; Marie Therese Holzer; Margarita Aleksandrovna Gromova; Or Aharonov; Zoltán Griger; Ihsane Hmamouchi; Imane El Bouchti; Zineb Baba; Margherita Giannini; François Maurier; Julien Campagne; Alain Meyer; Daman Langguth; Vidya Limaye; Merrilee Needham; Nilesh Srivastav; Marie Hudson; Océane Landon-Cardinal; Wilmer Gerardo Rojas Zuleta; Álvaro Arbeláez; Javier Cajas; José António Pereira Silva; João Eurico Fonseca; Olena Zimba; Doskaliuk Bohdana; Uyi Ima-Edomwonyi; Ibukunoluwa Dedeke; Emorinken Airenakho; Nwankwo Henry Madu; Abubakar Yerima; Hakeem Olaosebikan; A. Becky; Oruma Devi Koussougbo; Elisa Palalane; Ho So; Manuel Francisco Ugarte-Gil; Lyn Chinchay; José Proaño Bernaola; Victorio Pimentel; Hanan Mohammed Fathi; Reem Hamdy A. Mohammed; Ghita Harifi; Yurilís Fuentes-Silva; Karoll Cabriza; Jonathan Losanto; Nelly Colaman; Antonio Cachafeiro-Vilar; Generoso Guerra Bautista; Enrique Julio Giraldo Ho; Raúl González; Lilith Stange Nunez; M. Cristian Vergara; Jossiell Then Báez; Hugo Alonzo; Carlos Benito Santiago Pastelin; Rodrigo García Salinas; Alejandro Quiñónez Obiols; Nilmo Chávez; Andrea Bran Ordóñez; Gil Alberto Reyes Llerena; Radames Sierra-Zorita; Dina Arrieta; Eduardo Romero Hidalgo; Ricardo Saenz; M. Idania Escalante; Wendy Calapaqui; Ivonne Quezada; Gabriela Arredondo

doi:10.1093/rheumatology/kead180

Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys

R. Naveen, Parikshit Sen, Zoltán Griger, Jessica Day, Mrudula Joshi, Arvind Nune, Elena Nikiphorou, Sreoshy Saha, Ai Lyn Tan, Samuel Katsuyuki Shinjo, Nelly Ziade, Tsvetelina Velikova, Marcin Milchert, Kshitij Jagtap, Ioannis Parodis, Abraham Edgar Gracia-Ramos, Lorenzo Cavagna, Masataka Kuwana, Johannes Knitza, Yi Ming ChenAshima Makol, Vishwesh Agarwal, Aarat Patel, John D. Pauling, Chris Wincup, Bhupen Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Iris J. Colunga-Pedraza, Javier Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada Katchamart, Phonpen Akarawatcharangura Goo, Russka Shumnalieva, Leonardo Santos Hoff, Lina El Kibbi, Hussein Halabi, Binit Vaidya, Syahrul Sazliyana Shaharir, A. T.M.Tanveer Hasan, Dzifa Dey, Carlos Enrique Toro Gutiérrez, Carlo V. Caballero-Uribe, James B. Lilleker, Babur Salim, Tamer Gheita, Tulika Chatterjee, Oliver Distler, Miguel A. Saavedra, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta, Sinan Kardes, Laura Andreoli, Daniele Lini, Karen Screiber, Melinda Nagy Vince, Yogesh Preet Singh, Rajiv Ranjan, Avinash Jain, Sapan C. Pandya, Rakesh Kumar Pilania, Aman Sharma, M. Manesh Manoj, Vikas Gupta, Chengappa G. Kavadichanda, Pradeepta Sekhar Patro, Sajal Ajmani, Sanat Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha Shenoy, Ajay Asranna, Keerthi Talari Bommakanti, Anuj Shukla, Arunkumar R. Pande, Kunal Chandwar, Akanksha Ghodke, Hiya Boro, Zoha Zahid Fazal, Döndü Üsküdar Cansu, Reşit Ylldlrlm, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca Sambataro, Atzeni Fabiola, Marcello Govoni, Simone Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico Fusaro, Marco Sebastiani, Luca Quartuccio, Franco Franceschini, Pier Paolo Sainaghi, Giovanni Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo Venerito, Silvia Grignaschi, Alessandro Giollo, Alessia Alluno, Florenzo Ioannone, Marco Fornaro, Lisa S. Traboco, Suryo Anggoro Kusumo Wibowo, Jesús Loarce-Martos, Sergio Prieto-González, Raquel Aranega Gonzalez, Akira Yoshida, Ran Nakashima, Shinji Sato, Naoki Kimura, Yuko Kaneko, Takahisa Gono, Stylianos Tomaras, Fabian Nikolai Proft, Marie Therese Holzer, Margarita Aleksandrovna Gromova, Or Aharonov, Zoltán Griger, Ihsane Hmamouchi, Imane El Bouchti, Zineb Baba, Margherita Giannini, François Maurier, Julien Campagne, Alain Meyer, Daman Langguth, Vidya Limaye, Merrilee Needham, Nilesh Srivastav, Marie Hudson, Océane Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro Arbeláez, Javier Cajas, José António Pereira Silva, João Eurico Fonseca, Olena Zimba, Doskaliuk Bohdana, Uyi Ima-Edomwonyi, Ibukunoluwa Dedeke, Emorinken Airenakho, Nwankwo Henry Madu, Abubakar Yerima, Hakeem Olaosebikan, A. Becky, Oruma Devi Koussougbo, Elisa Palalane, Ho So, Manuel Francisco Ugarte-Gil, Lyn Chinchay, José Proaño Bernaola, Victorio Pimentel, Hanan Mohammed Fathi, Reem Hamdy A. Mohammed, Ghita Harifi, Yurilís Fuentes-Silva, Karoll Cabriza, Jonathan Losanto, Nelly Colaman, Antonio Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Raúl González, Lilith Stange Nunez, M. Cristian Vergara, Jossiell Then Báez, Hugo Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo Chávez, Andrea Bran Ordóñez, Gil Alberto Reyes Llerena, Radames Sierra-Zorita, Dina Arrieta, Eduardo Romero Hidalgo, Ricardo Saenz, M. Idania Escalante, Wendy Calapaqui, Ivonne Quezada, Gabriela Arredondo

Rheumatology

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	127-139
Number of pages	13
Journal	Rheumatology (United Kingdom)
Volume	63
Issue number	1
DOIs	https://doi.org/10.1093/rheumatology/kead180
State	Published - Jan 1 2024

Keywords

COVID-19 vaccines
disease exacerbation
idiopathic inflammatory myopathies
patient-reported outcomes

ASJC Scopus subject areas

Rheumatology
Pharmacology (medical)

Access to Document

10.1093/rheumatology/kead180

Cite this

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., ... Arredondo, G. (2024). Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys. Rheumatology (United Kingdom), 63(1), 127-139. https://doi.org/10.1093/rheumatology/kead180

Naveen, R, Sen, P, Griger, Z, Day, J, Joshi, M, Nune, A, Nikiphorou, E, Saha, S, Tan, AL, Shinjo, SK, Ziade, N, Velikova, T, Milchert, M, Jagtap, K, Parodis, I, Gracia-Ramos, AE, Cavagna, L, Kuwana, M, Knitza, J, Chen, YM, Makol, A, Agarwal, V, Patel, A, Pauling, JD, Wincup, C, Barman, B, Zamora Tehozol, EA, Rojas Serrano, J, García-De La Torre, I, Colunga-Pedraza, IJ, Merayo-Chalico, J, Chibuzo, OC, Katchamart, W, Akarawatcharangura Goo, P, Shumnalieva, R, Hoff, LS, El Kibbi, L, Halabi, H, Vaidya, B, Shaharir, SS, Hasan, ATMT, Dey, D, Toro Gutiérrez, CE, Caballero-Uribe, CV, Lilleker, JB, Salim, B, Gheita, T, Chatterjee, T, Distler, O, Saavedra, MA, Chinoy, H, Agarwal, V, Aggarwal, R, Gupta, L, Kardes, S, Andreoli, L, Lini, D, Screiber, K, Vince, MN, Singh, YP, Ranjan, R, Jain, A, Pandya, SC, Pilania, RK, Sharma, A, Manesh Manoj, M, Gupta, V, Kavadichanda, CG, Patro, PS, Ajmani, S, Phatak, S, Goswami, RP, Chowdhury, AC, Mathew, AJ, Shenoy, P, Asranna, A, Bommakanti, KT, Shukla, A, Pande, AR, Chandwar, K, Ghodke, A, Boro, H, Fazal, ZZ, Cansu, DÜ, Ylldlrlm, R, Gasparyan, AY, Del Papa, N, Sambataro, G, Fabiola, A, Govoni, M, Parisi, S, Bocci, EB, Sebastiani, GD, Fusaro, E, Sebastiani, M, Quartuccio, L, Franceschini, F, Sainaghi, PP, Orsolini, G, De Angelis, R, Danielli, MG, Venerito, V, Grignaschi, S, Giollo, A, Alluno, A, Ioannone, F, Fornaro, M, Traboco, LS, Wibowo, SAK, Loarce-Martos, J, Prieto-González, S, Gonzalez, RA, Yoshida, A, Nakashima, R, Sato, S, Kimura, N, Kaneko, Y, Gono, T, Tomaras, S, Proft, FN, Holzer, MT, Gromova, MA, Aharonov, O, Griger, Z, Hmamouchi, I, El Bouchti, I, Baba, Z, Giannini, M, Maurier, F, Campagne, J, Meyer, A, Langguth, D, Limaye, V, Needham, M, Srivastav, N, Hudson, M, Landon-Cardinal, O, Zuleta, WGR, Arbeláez, Á, Cajas, J, Silva, JAP, Fonseca, JE, Zimba, O, Bohdana, D, Ima-Edomwonyi, U, Dedeke, I, Airenakho, E, Madu, NH, Yerima, A, Olaosebikan, H, Becky, A, Koussougbo, OD, Palalane, E, So, H, Ugarte-Gil, MF, Chinchay, L, Bernaola, JP, Pimentel, V, Fathi, HM, Mohammed, RHA, Harifi, G, Fuentes-Silva, Y, Cabriza, K, Losanto, J, Colaman, N, Cachafeiro-Vilar, A, Bautista, GG, Ho, EJG, González, R, Nunez, LS, Cristian Vergara, M, Báez, JT, Alonzo, H, Pastelin, CBS, Salinas, RG, Obiols, AQ, Chávez, N, Ordóñez, AB, Llerena, GAR, Sierra-Zorita, R, Arrieta, D, Hidalgo, ER, Saenz, R, Idania Escalante, M, Calapaqui, W, Quezada, I & Arredondo, G 2024, '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, pp. 127-139. https://doi.org/10.1093/rheumatology/kead180

@article{4081c58b5a034094bab4e67d3227177b,

title = "Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys",

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.",

keywords = "COVID-19 vaccines, disease exacerbation, idiopathic inflammatory myopathies, patient-reported outcomes",

author = "R. Naveen and Parikshit Sen and Zolt{\'a}n Griger and Jessica Day and Mrudula Joshi and Arvind Nune and Elena Nikiphorou and Sreoshy Saha and Tan, {Ai Lyn} and Shinjo, {Samuel Katsuyuki} and Nelly Ziade and Tsvetelina Velikova and Marcin Milchert and Kshitij Jagtap and Ioannis Parodis and Gracia-Ramos, {Abraham Edgar} and Lorenzo Cavagna and Masataka Kuwana and Johannes Knitza and Chen, {Yi Ming} and Ashima Makol and Vishwesh Agarwal and Aarat Patel and Pauling, {John D.} and Chris Wincup and Bhupen Barman and {Zamora Tehozol}, {Erick Adrian} and {Rojas Serrano}, Jorge and {Garc{\'i}a-De La Torre}, Ignacio and Colunga-Pedraza, {Iris J.} and Javier Merayo-Chalico and Chibuzo, {Okwara Celestine} and Wanruchada Katchamart and {Akarawatcharangura Goo}, Phonpen and Russka Shumnalieva and Hoff, {Leonardo Santos} and {El Kibbi}, Lina and Hussein Halabi and Binit Vaidya and Shaharir, {Syahrul Sazliyana} and Hasan, {A. T.M.Tanveer} and Dzifa Dey and {Toro Guti{\'e}rrez}, {Carlos Enrique} and Caballero-Uribe, {Carlo V.} and Lilleker, {James B.} and Babur Salim and Tamer Gheita and Tulika Chatterjee and Oliver Distler and Saavedra, {Miguel A.} and Hector Chinoy and Vikas Agarwal and Rohit Aggarwal and Latika Gupta and Sinan Kardes and Laura Andreoli and Daniele Lini and Karen Screiber and Vince, {Melinda Nagy} and Singh, {Yogesh Preet} and Rajiv Ranjan and Avinash Jain and Pandya, {Sapan C.} and Pilania, {Rakesh Kumar} and Aman Sharma and {Manesh Manoj}, M. and Vikas Gupta and Kavadichanda, {Chengappa G.} and Patro, {Pradeepta Sekhar} and Sajal Ajmani and Sanat Phatak and Goswami, {Rudra Prosad} and Chowdhury, {Abhra Chandra} and Mathew, {Ashish Jacob} and Padnamabha Shenoy and Ajay Asranna and Bommakanti, {Keerthi Talari} and Anuj Shukla and Pande, {Arunkumar R.} and Kunal Chandwar and Akanksha Ghodke and Hiya Boro and Fazal, {Zoha Zahid} and Cansu, {D{\"o}nd{\"u} {\"U}sk{\"u}dar} and Re{\c s}it Ylldlrlm and Gasparyan, {Armen Yuri} and {Del Papa}, Nicoletta and Gianluca Sambataro and Atzeni Fabiola and Marcello Govoni and Simone Parisi and Bocci, {Elena Bartoloni} and Sebastiani, {Gian Domenico} and Enrico Fusaro and Marco Sebastiani and Luca Quartuccio and Franco Franceschini and Sainaghi, {Pier Paolo} and Giovanni Orsolini and {De Angelis}, Rossella and Danielli, {Maria Giovanna} and Vincenzo Venerito and Silvia Grignaschi and Alessandro Giollo and Alessia Alluno and Florenzo Ioannone and Marco Fornaro and Traboco, {Lisa S.} and Wibowo, {Suryo Anggoro Kusumo} and Jes{\'u}s Loarce-Martos and Sergio Prieto-Gonz{\'a}lez and Gonzalez, {Raquel Aranega} and Akira Yoshida and Ran Nakashima and Shinji Sato and Naoki Kimura and Yuko Kaneko and Takahisa Gono and Stylianos Tomaras and Proft, {Fabian Nikolai} and Holzer, {Marie Therese} and Gromova, {Margarita Aleksandrovna} and Or Aharonov and Zolt{\'a}n Griger and Ihsane Hmamouchi and {El Bouchti}, Imane and Zineb Baba and Margherita Giannini and Fran{\c c}ois Maurier and Julien Campagne and Alain Meyer and Daman Langguth and Vidya Limaye and Merrilee Needham and Nilesh Srivastav and Marie Hudson and Oc{\'e}ane Landon-Cardinal and Zuleta, {Wilmer Gerardo Rojas} and {\'A}lvaro Arbel{\'a}ez and Javier Cajas and Silva, {Jos{\'e} Ant{\'o}nio Pereira} and Fonseca, {Jo{\~a}o Eurico} and Olena Zimba and Doskaliuk Bohdana and Uyi Ima-Edomwonyi and Ibukunoluwa Dedeke and Emorinken Airenakho and Madu, {Nwankwo Henry} and Abubakar Yerima and Hakeem Olaosebikan and A. Becky and Koussougbo, {Oruma Devi} and Elisa Palalane and Ho So and Ugarte-Gil, {Manuel Francisco} and Lyn Chinchay and Bernaola, {Jos{\'e} Proa{\~n}o} and Victorio Pimentel and Fathi, {Hanan Mohammed} and Mohammed, {Reem Hamdy A.} and Ghita Harifi and Yuril{\'i}s Fuentes-Silva and Karoll Cabriza and Jonathan Losanto and Nelly Colaman and Antonio Cachafeiro-Vilar and Bautista, {Generoso Guerra} and Ho, {Enrique Julio Giraldo} and Ra{\'u}l Gonz{\'a}lez and Nunez, {Lilith Stange} and {Cristian Vergara}, M. and B{\'a}ez, {Jossiell Then} and Hugo Alonzo and Pastelin, {Carlos Benito Santiago} and Salinas, {Rodrigo Garc{\'i}a} and Obiols, {Alejandro Qui{\~n}{\'o}nez} and Nilmo Ch{\'a}vez and Ord{\'o}{\~n}ez, {Andrea Bran} and Llerena, {Gil Alberto Reyes} and Radames Sierra-Zorita and Dina Arrieta and Hidalgo, {Eduardo Romero} and Ricardo Saenz and {Idania Escalante}, M. and Wendy Calapaqui and Ivonne Quezada and Gabriela Arredondo",

year = "2024",

month = jan,

day = "1",

doi = "10.1093/rheumatology/kead180",

language = "English (US)",

volume = "63",

pages = "127--139",

journal = "Rheumatology (United Kingdom)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "1",

}

TY - JOUR

T1 - Flares in IIMs and the timeline following COVID-19 vaccination

T2 - a combined analysis of the COVAD-1 and -2 surveys

AU - Naveen, R.

AU - Sen, Parikshit

AU - Griger, Zoltán

AU - Day, Jessica

AU - Joshi, Mrudula

AU - Nune, Arvind

AU - Nikiphorou, Elena

AU - Saha, Sreoshy

AU - Tan, Ai Lyn

AU - Shinjo, Samuel Katsuyuki

AU - Ziade, Nelly

AU - Velikova, Tsvetelina

AU - Milchert, Marcin

AU - Jagtap, Kshitij

AU - Parodis, Ioannis

AU - Gracia-Ramos, Abraham Edgar

AU - Cavagna, Lorenzo

AU - Kuwana, Masataka

AU - Knitza, Johannes

AU - Chen, Yi Ming

AU - Makol, Ashima

AU - Agarwal, Vishwesh

AU - Patel, Aarat

AU - Pauling, John D.

AU - Wincup, Chris

AU - Barman, Bhupen

AU - Zamora Tehozol, Erick Adrian

AU - Rojas Serrano, Jorge

AU - García-De La Torre, Ignacio

AU - Colunga-Pedraza, Iris J.

AU - Merayo-Chalico, Javier

AU - Chibuzo, Okwara Celestine

AU - Katchamart, Wanruchada

AU - Akarawatcharangura Goo, Phonpen

AU - Shumnalieva, Russka

AU - Hoff, Leonardo Santos

AU - El Kibbi, Lina

AU - Halabi, Hussein

AU - Vaidya, Binit

AU - Shaharir, Syahrul Sazliyana

AU - Hasan, A. T.M.Tanveer

AU - Dey, Dzifa

AU - Toro Gutiérrez, Carlos Enrique

AU - Caballero-Uribe, Carlo V.

AU - Lilleker, James B.

AU - Salim, Babur

AU - Gheita, Tamer

AU - Chatterjee, Tulika

AU - Distler, Oliver

AU - Saavedra, Miguel A.

AU - Chinoy, Hector

AU - Agarwal, Vikas

AU - Aggarwal, Rohit

AU - Gupta, Latika

AU - Kardes, Sinan

AU - Andreoli, Laura

AU - Lini, Daniele

AU - Screiber, Karen

AU - Vince, Melinda Nagy

AU - Singh, Yogesh Preet

AU - Ranjan, Rajiv

AU - Jain, Avinash

AU - Pandya, Sapan C.

AU - Pilania, Rakesh Kumar

AU - Sharma, Aman

AU - Manesh Manoj, M.

AU - Gupta, Vikas

AU - Kavadichanda, Chengappa G.

AU - Patro, Pradeepta Sekhar

AU - Ajmani, Sajal

AU - Phatak, Sanat

AU - Goswami, Rudra Prosad

AU - Chowdhury, Abhra Chandra

AU - Mathew, Ashish Jacob

AU - Shenoy, Padnamabha

AU - Asranna, Ajay

AU - Bommakanti, Keerthi Talari

AU - Shukla, Anuj

AU - Pande, Arunkumar R.

AU - Chandwar, Kunal

AU - Ghodke, Akanksha

AU - Boro, Hiya

AU - Fazal, Zoha Zahid

AU - Cansu, Döndü Üsküdar

AU - Ylldlrlm, Reşit

AU - Gasparyan, Armen Yuri

AU - Del Papa, Nicoletta

AU - Sambataro, Gianluca

AU - Fabiola, Atzeni

AU - Govoni, Marcello

AU - Parisi, Simone

AU - Bocci, Elena Bartoloni

AU - Sebastiani, Gian Domenico

AU - Fusaro, Enrico

AU - Sebastiani, Marco

AU - Quartuccio, Luca

AU - Franceschini, Franco

AU - Sainaghi, Pier Paolo

AU - Orsolini, Giovanni

AU - De Angelis, Rossella

AU - Danielli, Maria Giovanna

AU - Venerito, Vincenzo

AU - Grignaschi, Silvia

AU - Giollo, Alessandro

AU - Alluno, Alessia

AU - Ioannone, Florenzo

AU - Fornaro, Marco

AU - Traboco, Lisa S.

AU - Wibowo, Suryo Anggoro Kusumo

AU - Loarce-Martos, Jesús

AU - Prieto-González, Sergio

AU - Gonzalez, Raquel Aranega

AU - Yoshida, Akira

AU - Nakashima, Ran

AU - Sato, Shinji

AU - Kimura, Naoki

AU - Kaneko, Yuko

AU - Gono, Takahisa

AU - Tomaras, Stylianos

AU - Proft, Fabian Nikolai

AU - Holzer, Marie Therese

AU - Gromova, Margarita Aleksandrovna

AU - Aharonov, Or

AU - Griger, Zoltán

AU - Hmamouchi, Ihsane

AU - El Bouchti, Imane

AU - Baba, Zineb

AU - Giannini, Margherita

AU - Maurier, François

AU - Campagne, Julien

AU - Meyer, Alain

AU - Langguth, Daman

AU - Limaye, Vidya

AU - Needham, Merrilee

AU - Srivastav, Nilesh

AU - Hudson, Marie

AU - Landon-Cardinal, Océane

AU - Zuleta, Wilmer Gerardo Rojas

AU - Arbeláez, Álvaro

AU - Cajas, Javier

AU - Silva, José António Pereira

AU - Fonseca, João Eurico

AU - Zimba, Olena

AU - Bohdana, Doskaliuk

AU - Ima-Edomwonyi, Uyi

AU - Dedeke, Ibukunoluwa

AU - Airenakho, Emorinken

AU - Madu, Nwankwo Henry

AU - Yerima, Abubakar

AU - Olaosebikan, Hakeem

AU - Becky, A.

AU - Koussougbo, Oruma Devi

AU - Palalane, Elisa

AU - So, Ho

AU - Ugarte-Gil, Manuel Francisco

AU - Chinchay, Lyn

AU - Bernaola, José Proaño

AU - Pimentel, Victorio

AU - Fathi, Hanan Mohammed

AU - Mohammed, Reem Hamdy A.

AU - Harifi, Ghita

AU - Fuentes-Silva, Yurilís

AU - Cabriza, Karoll

AU - Losanto, Jonathan

AU - Colaman, Nelly

AU - Cachafeiro-Vilar, Antonio

AU - Bautista, Generoso Guerra

AU - Ho, Enrique Julio Giraldo

AU - González, Raúl

AU - Nunez, Lilith Stange

AU - Cristian Vergara, M.

AU - Báez, Jossiell Then

AU - Alonzo, Hugo

AU - Pastelin, Carlos Benito Santiago

AU - Salinas, Rodrigo García

AU - Obiols, Alejandro Quiñónez

AU - Chávez, Nilmo

AU - Ordóñez, Andrea Bran

AU - Llerena, Gil Alberto Reyes

AU - Sierra-Zorita, Radames

AU - Arrieta, Dina

AU - Hidalgo, Eduardo Romero

AU - Saenz, Ricardo

AU - Idania Escalante, M.

AU - Calapaqui, Wendy

AU - Quezada, Ivonne

AU - Arredondo, Gabriela

PY - 2024/1/1

Y1 - 2024/1/1

N2 - 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.

AB - 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.

KW - COVID-19 vaccines

KW - disease exacerbation

KW - idiopathic inflammatory myopathies

KW - patient-reported outcomes

UR - http://www.scopus.com/inward/record.url?scp=85180733005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85180733005&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kead180

DO - 10.1093/rheumatology/kead180

M3 - Article

C2 - 37084267

AN - SCOPUS:85180733005

SN - 1462-0324

VL - 63

SP - 127

EP - 139

JO - Rheumatology (United Kingdom)

JF - Rheumatology (United Kingdom)

IS - 1

ER -

Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys

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