Post-mRNA vaccine flares in autoimmune inflammatory rheumatic diseases: Results from the COronavirus National Vaccine registry for ImmuNe diseases SINGapore (CONVIN-SING)

• DOI: 10.1016/j.jaut.2022.102959
• Publication Date: 2022-11-29T07:49:55Z
• Authors: Margaret Ma; Amelia Santosa; Warren Fong; Li-Ching Chew; Andrea HL Low; Annie Law; Yih Jia Poh; Siaw Ing Yeo; Ying Ying Leung; Victoria WW Ng; Joshua ZE Koh; Sen Hee Tay; Anselm Mak; Gim Gee Teng; Chuanhui Xu; Johnston GX Tang; Kok Ooi Kong; Stanley Angkodjojo; Wei-Rui Goh; Tyng Yu Chuah; Nur Emillia Roslan; Thaschawee Arkach...; Kai Liang Teh; Melonie Srirangan...; Teck Choon Tan; Kee Fong Phang; Qai Ven Yap; Yiong Huak Chan; Peter PM Cheung; Manjari Lahiri
• Keywords: Hydroxychloroquine

Studies of flares autoimmune inflammatory rheumatic diseases (AIIRD) after COVID-19 mRNA vaccination are limited by small sample size, short follow up or at risk selection bias.A national retrospective cohort study consecutive AIIRD patients ≥12 years old, across 8 hospitals who received least one dose a vaccine. Patients were included from the date 1st vaccine and censored time flare on clinic visit 3 months entry, whichever came first. Predictors determined Cox proportional hazards analysis.4627 (73% Chinese, 71% female) median (IQR) age 61 (48, 70) included; 42% Rheumatoid arthritis, 14% Systemic lupus erythematosus 11% Psoriatic arthritis. 47% in remission, 41% low disease activity, 10% moderate activity 1% high activity. 18% flared, which 11.7% within 3-month period interest. 11.8% improved. Median time-to-flare was 60 (30, 114) days. 25% self-limiting, 61% mild-moderate severe. Older (53-65 >66 years) had lower [HR 0.6 (95% CI 0.5-0.8) 0.7 (0.6-0.8) respectively]. with arthritis active higher 1.5 (1.2-2.0) 1.4 (1.2-1.6), Treatment conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), immunosuppression prednisolone also associated an increased (1.1-2), 1.2 (1.1-1.4) (1.2-1.8) for ≤7.5 mg respectively].There moderately rate but improvement several patients. Severe hospitalisation rare. Thus, remains safe highly recommended.