Rheumatoid Arthritis Flare-ups Following Immunization with Sinopharm Inactivated Virus-based COVID-19 Vaccine
Iranian Journal of Emergency Medicine,
Vol. 10 No. 1 (2023),
30 Azar 2022
,
Page e24
https://doi.org/10.22037/ijem.v10i1.42970
Abstract
Introduction: This study aimed to investigate the incidence of rheumatoid arthritis (RA) flare-ups following immunization with the Sinopharm COVID-19 inactivated virus-based vaccine.
Methods: We conducted a retrospective observational study at the Rheumatology Clinic of Imam Hossein Hospital, incorporating 200 RA patients in remission undergoing non-biologic Disease-Modifying Antirheumatic Drugs (DMARDs) treatments. A rheumatologist confirmed a flare-up based on patients complain of arthralgia and joint stiffness and complete examination of joints over a three-month period following vaccination.
Results: Twelve percent of all included patients experienced symptom recurrence. The average age of patients with flare-ups was significantly higher, but no gender-based differences were observed (p<0.001 and p=0.071, respectively). The second vaccine dose resulted in a higher number of symptom flares compared to the first dose (9.30% vs. 3.0%, p < 0.001). No significant differences were observed between patients experiencing flare-ups after the first dose and the second dose in terms of the number of involved joints (p=0.321) and the time gap from vaccination to symptom recurrence (p=0.526). No patients required hospitalization, and prednisolone dosage adjustments effectively managed symptoms.
Conclusion: The occurrence of flare-ups was relatively low after the Sinopharm COVID-19 vaccination in RA patients undergoing treatment with DMARDs during remission. The majority of these flares were mild and no hospitalizations were required.
- Rheumatoid arthritis
- COVID-19
- Sinopharm
- Flare-ups
How to Cite
References
Moghadas SM, Vilches TN, Zhang K, Wells CR, Shoukat A, Singer BH, et al. The Impact of Vaccination on Coronavirus Disease 2019 (COVID-19) Outbreaks in the United States. Clin Infect Dis. 2021 Dec 16;73(12):2257–64.
Bijlsma JWJ. Response to: ‘Correspondence on “EULAR December 2020 View points on SARS-CoV-2 vaccination in patients with RMDs”’ by Bugatti et al. Ann Rheum Dis. 2021 Oct;80(10):e157–e157.
Curtis JR, Johnson SR, Anthony DD, Arasaratnam RJ, Baden LR, Bass AR, et al. American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3. Arthritis Rheumatol [Internet]. 2021 Oct [cited 2023 Jul 29];73(10). Available from: https://onlinelibrary.wiley.com/doi/10.1002/art.41928
Safary A, Esalatmanesh K, Eftekharsadat AT, Jafari Nakjavani MR, Khabbazi A. Autoimmune inflammatory rheumatic diseases post-COVID‐19 vaccination. Int Immunopharmacol. 2022 Sep;110:109061.
Boekel L, Hooijberg F, Van Kempen ZLE, Vogelzang EH, Tas SW, Killestein J, et al. Perspective of patients with autoimmune diseases on COVID-19 vaccination. Lancet Rheumatol. 2021 Apr;3(4):e241–3.
Guimarães LE, Baker B, Perricone C, Shoenfeld Y. Vaccines, adjuvants and autoimmunity. Pharmacol Res. 2015 Oct;100:190–209.
Medeiros-Ribeiro AC, Aikawa NE, Saad CGS, Yuki EFN, Pedrosa T, Fusco SRG, et al. Immunogenicity and safety of the CoronaVac inactivated vaccine in patients with autoimmune rheumatic diseases: a phase 4 trial. Nat Med. 2021 Oct;27(10):1744–51.
Geng Y, Fan Y, Wang Y, Deng X, Ji L, Zhang X, et al. Flare and change in disease activity among patients with stable rheumatoid arthritis following coronavirus disease 2019 vaccination: a prospective Chinese cohort study. Chin Med J (Engl) [Internet]. 2023 Mar 15 [cited 2023 Jul 26];Publish Ahead of Print. Available from: https://journals.lww.com/10.1097/CM9.0000000000002562
Xie Y, Liu Y, Liu Y. The Flare of Rheumatic Disease After SARS-CoV-2 Vaccination: A Review. Front Immunol. 2022 Jul 4;13:919979.
Fan Y, Geng Y, Wang Y, Deng X, Li G, Zhao J, et al. Safety and disease flare of autoimmune inflammatory rheumatic diseases: a large real-world survey on inactivated COVID-19 vaccines. Ann Rheum Dis. 2022 Mar;81(3):443–5.
Connolly CM, Ruddy JA, Boyarsky BJ, Barbur I, Werbel WA, Geetha D, et al. Disease Flare and Reactogenicity in Patients With Rheumatic and Musculoskeletal Diseases Following TWO‐DOSE SARS – COV ‐2 Messenger RNA Vaccination. Arthritis Rheumatol. 2022 Jan;74(1):28–32.
Álvaro-Gracia JM, Sanchez-Piedra C, Culqui D, Rosello R, Garcia-Dorta A, Campos C, et al. Effects of COVID-19 vaccination on disease activity in patients with rheumatoid arthritis and psoriatic arthritis on targeted therapy in the COVIDSER study. RMD Open. 2023 Mar;9(1):e002936.
Pinte L, Negoi F, Ionescu GD, Caraiola S, Balaban DV, Badea C, et al. COVID-19 Vaccine Does Not Increase the Risk of Disease Flare-Ups among Patients with Autoimmune and Immune-Mediated Diseases. J Pers Med. 2021 Dec 2;11(12):1283.
Lee YW, Lim SY, Lee JH, Lim JS, Kim M, Kwon S, et al. Adverse Reactions of the Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Healthcare Workers in Korea. J Korean Med Sci. 2021;36(21):e153.
Tedeschi SK, Stratton J, Ellrodt JE, Whelan MG, Hayashi K, Yoshida K, et al. Rheumatoid arthritis disease activity assessed by patient-reported outcomes and flow cytometry before and after an additional dose of COVID-19 vaccine. Ann Rheum Dis. 2022 Jul;81(7):1045–8.
Filippini F, Giacomelli M, Bazzani C, Fredi M, Semeraro P, Tomasi C, et al. Efficacy of COVID-19 mRNA vaccination in patients with autoimmune disorders: humoral and cellular immune response. BMC Med. 2023 Jun 14;21(1):210.
Barnes E, Goodyear CS, Willicombe M, Gaskell C, Siebert S, I De Silva T, et al. SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease. Nat Med. 2023 Jul;29(7):1760–74.
Bixio R, Bertelle D, Masia M, Pistillo F, Carletto A, Rossini M. Incidence of Disease Flare After BNT162b2 Coronavirus Disease 2019 Vaccination in Patients With Rheumatoid Arthritis in Remission. ACR Open Rheumatol. 2021 Dec;3(12):832–3.
Fragoulis GE, Bournia VK, Mavrea E, Evangelatos G, Fragiadaki K, Karamanakos A, et al. COVID-19 vaccine safety and nocebo-prone associated hesitancy in patients with systemic rheumatic diseases: a cross-sectional study. Rheumatol Int. 2022 Jan;42(1):31–9.
Haslak F, Gunalp A, Cebi MN, Yildiz M, Adrovic A, Sahin S, et al. Early experience of COVID‐19 vaccine‐related adverse events among adolescents and young adults with rheumatic diseases: A single‐center study. Int J Rheum Dis. 2022 Mar;25(3):353–63.
Barbhaiya M, Levine JM, Bykerk VP, Jannat-Khah D, Mandl LA. Systemic rheumatic disease flares after SARS-CoV-2 vaccination among rheumatology outpatients in New York City. Ann Rheum Dis. 2021 Oct;80(10):1352–4.
- Abstract Viewed: 149 times
- pdf Downloaded: 599 times