Risk of giant cell arteritis and polymyalgia rheumatica following COVID-19 vaccination: a global pharmacovigilance study

Mettler, C.; Jonville-Béra, Annie Pierre; Grandvuillemin, Aurélie; Tréluyer, Jean‐Marc; Terrier, Benjamin; Chouchana, Laurent

doi:10.1093/rheumatology/keab756

Cited by 44 publications

(41 citation statements)

References 6 publications

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“…Patients with GCA are more severely affected by SARS-CoV-2 if elderly, male, suffering from multiple comorbidities, or on more than 10 mg prednisolone 16 . Following vaccination, an increased risk for GCA has been implied with a reporting odds ratio (OR) of 2.7 (95% CI: 2.3–3.2) 17 . This was, however, not significant if compared to use of influenza vaccines (0.5, 95% CI: 0.4–0.7).…”

Section: Vascularmentioning

confidence: 99%

Neuro-Ophthalmic Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Related Infection and Vaccination

Petzold

2022

Asia-Pacific Journal of Ophthalmology

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic created a unique opportunity to study the effects of infection and vaccination on disease. The year 2020 was dominated by infection and its consequences. The year 2021 was dominated by vaccination and its consequences. It will still take several years for full maturation of databases required for robust epidemiological studies. Therefore, this review on the implications for neuro-ophthalmology draws on resources presently available including reported adverse reactions to vaccination. Illustrative clinical cases are presented. The spectrum of pathology following infection with SARS-CoV-2 falls into 4 main categories: autoimmune, vascular, sequelae of brain damage, and miscellaneous. This review is exhaustive, but the most common conditions discussed relate to headaches and associated symptoms; vertigo, diplopia, and nystagmus; vascular complications of the eye and brain; cranial nerve (mono-)neuropathies; photophobia, ocular discomfort, and optic neuritis. Of the 36 main adverse reactions reviewed, vaccine-induced immune thrombotic thrombocytopenia is a novel complication requiring specific hematological management. Updated diagnostic criteria are summarized. It is relevant to remember taking a medication history because of side effects and to recognize the relevance of comorbidities. The clinical assessment can frequently be performed virtually. Consensus recommendations on telemedicine and the virtual assessment are summarized in a practical and compressed format. The review concludes with an epidemiological tetralogy to interrogate, in future studies, associations with (1) SARS-CoV-2 pandemic infection, (2) SARS-CoV-2 worldwide vaccination, and (3) the possibility of a rebound effect of infections in the pandemic aftermath.

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Section: Vascularmentioning

confidence: 99%

Neuro-Ophthalmic Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Related Infection and Vaccination

Petzold

2022

Asia-Pacific Journal of Ophthalmology

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“…Some cases of GCA following SARS-CoV-2 vaccination have also been described. Using VigiBase analysis (26,246,383 reports until 30 June 2021 with 1,295,482 reports concerning COVID-19 vaccines), Mettler et al [34] reported 147 cases of GCA, 290 cases of polymyalgia rheumatica (PMR) and 9 GCA with PMR cases, which resulted in an increased risk of GCA (ROR [reporting odds ratio] = 2.7 [95% CI: 2.3; 3.2]) and PMR (ROR = 2.3 [95% CI: 2.0; 2.6]) following SARS-CoV-2 vaccination, whereas it was not the case after influenza vaccination for GCA (ROR = 0.5; [95% CI: 0.4; 0.7]) and PMR (ROR = 0.2; [95% CI: 0.2; 0.2]). Median (IQR) time from vaccination to first symptoms onset was 4 (1-14) days.…”

Section: Severe Acute Respiratory Syndrome Coronavirus-2 (Sars-cov-2)mentioning

confidence: 99%

Mimickers of Large Vessel Giant Cell Arteritis

Greigert

Ornetti²,

Bonnotte

et al. 2022

JCM

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Giant cell arteritis (GCA) is a large-vessel granulomatous vasculitis occurring in patients over 50-year-old. Diagnosis can be challenging because there is no specific biological test or other diagnoses to consider. Two main phenotypes of GCA are distinguished and can be associated. First, cranial GCA, whose diagnosis is usually confirmed by the evidence of a non-necrotizing granulomatous panarteritis on temporal artery biopsy. Second, large-vessel GCA, whose related symptoms are less specific (fever, asthenia, and weight loss) and for which other diagnoses must be implemented if there is neither cephalic GCA nor associated polymyalgia rheumatica (PMR) features chronic infection (tuberculosis, Coxiella burnetti), IgG4-related disease, Erdheim Chester disease, and other primary vasculitis (Behçet disease, relapsing polychondritis, or VEXAS syndrome). Herein, we propose a review of the main differential diagnoses to be considered regarding large vessel vasculitis.

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“…COVID-19 vaccination is a global effort. In Spain, over 79% of the population is fully vaccinated and, although the benefits obtained from immunization clearly outweigh any potential risks, we have noticed a few case reports of autoimmune diseases possibly triggered by the vaccine in the last year [ 1 , 2 ].…”

mentioning

confidence: 99%

“…Although they seem to be rare events, the true scope of this issue is still uncertain. Recently, a pharmacovigilance study was published revealing a higher incidence of both giant GCA and polymyalgia rheumatica (PMR) following mRNA vaccines supporting a causal relationship [ 1 ]. Since the possibility of incidental co-existence in the present case cannot be discarded, further studies should be undertaken to better understand the potential uncommon effects of these vaccines.…”

mentioning

confidence: 99%

New-onset giant cell arteritis following COVID-19 mRNA (BioNTech/Pfizer) vaccine: a double-edged sword?

et al. 2022

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Risk of giant cell arteritis and polymyalgia rheumatica following COVID-19 vaccination: a global pharmacovigilance study

Cited by 44 publications

References 6 publications

Neuro-Ophthalmic Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Related Infection and Vaccination

Neuro-Ophthalmic Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Related Infection and Vaccination

Mimickers of Large Vessel Giant Cell Arteritis

New-onset giant cell arteritis following COVID-19 mRNA (BioNTech/Pfizer) vaccine: a double-edged sword?

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