Correspondence on ‘EULAR December 2020 viewpoints on SARS-CoV-2 vaccination in patients with RMDs’

Bugatti, Serena; Balduzzi, Silvia; Stefano, Ludovico De; Manzo, Antonio; Xoxi, Blerina; Bogliolo, Laura; Monti, Sara; Montecucco, Carlomaurizio

doi:10.1136/annrheumdis-2021-220541

Cited by 13 publications

(9 citation statements)

References 15 publications

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“…Patients with rheumatoid arthritis (RA) are twofold more vulnerable to infections that result in hospitalisation and impaired quality of life. 1 With consideration to the benefits of vaccination outweighing the risks, the European Alliance of Associations for Rheumatology (EULAR) 2 recommends that patients with RA should receive COVID-19 vaccines without needing major adjustment to their ongoing treatment regimens. However, one of the major barriers to vaccine uptake among patients with RA is the fear of arthritis flare despite non-relevant evidence from landmark trials and few case reports in the post marketing.…”

Section: Introductionmentioning

confidence: 99%

Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

et al. 2021

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ObjectivesTo investigate the relationship between COVID-19 full vaccination (two completed doses) and possible arthritis flare.MethodsPatients with rheumatoid arthritis (RA) were identified from population-based electronic medical records with vaccination linkage and categorised into BNT162b2 (mRNA vaccine), CoronaVac (inactive virus vaccine) and non-vaccinated groups. The risk of possible arthritis flare after vaccination was compared using a propensity-weighted cohort study design. We defined possible arthritis flare as hospitalisation and outpatient consultation related to RA or reactive arthritis, based on diagnosis records during the episode. Weekly prescriptions of rheumatic drugs since the launch of COVID-19 vaccination programme were compared to complement the findings from a diagnosis-based analysis.ResultsAmong 5493 patients with RA (BNT162b2: 653; CoronaVac: 671; non-vaccinated: 4169), propensity-scored weighted Poisson regression showed no significant association between arthritis flare and COVID-19 vaccination ((BNT162b2: adjusted incidence rate ratio 0.86, 95% Confidence Interval 0.73 to 1.01); CoronaVac: 0.87 (0.74 to 1.02)). The distribution of weekly rheumatic drug prescriptions showed no significant differences among the three groups since the launch of the mass vaccination programme (all p values >0.1 from Kruskal-Wallis test).ConclusionsCurrent evidence does not support that full vaccination of mRNA or inactivated virus COVID-19 vaccines is associated with possible arthritis flare.

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Section: Introductionmentioning

confidence: 99%

Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

et al. 2021

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“…Furthermore, COVID-19 infection itself may also precipitate flares of rheumatic diseases. Therefore, the European Alliance of Associations for Rheumatology (EULAR) recommended COVID-19 vaccination for patients with rheumatic diseases [1]. On the other hand, several trials have reported on the safety of vaccines, and the association between disease flare and vaccination has also been an important issue.…”

Section: Introductionmentioning

confidence: 99%

A flare of Still’s disease following COVID-19 vaccination in a 34-year-old patient

et al. 2021

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“…4 To ensure appropriate SARS-CoV-2 vaccination, the last EULAR advise was to refer to a rheumatologist. 5 The American College of Rheumatology (ACR) has recommended to vaccinate Rtx-treated patients not earlier than 5 months after the last administration with the next cycle given not earlier than 2-4 weeks thereafter. 6 In any case, the combination of B cell-depleting therapy with vaccination has been quite a challenge for patients and physicians-especially since it became clear that Rtx therapy may be associated with unfavourable outcomes in B cell-depleted patients.…”

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confidence: 99%

Correspondence on ‘SARS-CoV-2 vaccination in rituximab-treated patients: evidence for impaired humoral but inducible cellular immune response’

et al. 2021

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The role of SARS-CoV-2-specific antibodies in COVID-19 is not well established: reports indicate an increased risk of severe COVID-19 infections in Rtx-treated patients, 7 whereas other data have suggested that B cells are dispensable for resolving such infections. 11 The here presented data indicate that polyfunctional antiviral T cell responses are raised after SARS-CoV-2 vaccination in this high-risk population suggesting protection in the absence of virus-specific antibodies.

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Correspondence on ‘EULAR December 2020 viewpoints on SARS-CoV-2 vaccination in patients with RMDs’

Cited by 13 publications

References 15 publications

Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

A flare of Still’s disease following COVID-19 vaccination in a 34-year-old patient

Correspondence on ‘SARS-CoV-2 vaccination in rituximab-treated patients: evidence for impaired humoral but inducible cellular immune response’

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