Effects of COVID-19 vaccination on disease activity in patients with rheumatoid arthritis and psoriatic arthritis on targeted therapy in the COVIDSER study
Carlos Sanchez-Piedra,
Jose M Alvaro-Gracia,
Isabel Castrejón,
Sara Manrique-Arija,
Carlos Rodríguez-Lozano,
Federico Díaz-González,
Rosa Roselló,
Mercedes Freire-González,
Dolores Ruiz-Montesinos,
Cristina Bohorquez,
Enrique González-Dávila,
Dante Culqui,
Alicia Garcia-Dorta,
Cristina Campos,
Inmaculada Ros-Vilamajo,
Rafael Caliz,
Lourdes Mateo Soria,
Noemí Busquets,
Fernando Sánchez-Alonso
Affiliations
Carlos Sanchez-Piedra
2 Spanish Agency of Health Technology Assessment, Instituto de Salud Carlos III, Madrid, Spain
Jose M Alvaro-Gracia
4 Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
Isabel Castrejón
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Sara Manrique-Arija
7 Rheumatology Department, Hospital Regional Universitario de Málaga, Malaga, Spain
Carlos Rodríguez-Lozano
Rheumatology Department, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas, Gran Canaria, Spain
Federico Díaz-González
Department of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain
Rosa Roselló
Department of Rheumatology, Hospital San Jorge, Huesca, Spain
Mercedes Freire-González
1Pharmacy Department, La Paz University Hospital, Madrid, Spain
Objective To investigate the influence of COVID-19 vaccination on disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients under targeted therapies.Patients and methods 1765 vaccinated patients COVID-19, 1178 (66.7%) with RA and 587 (33.3%) with PsA from the COVID-19 registry in patients with rheumatic diseases (COVIDSER) project, were included. Demographics, disease characteristics, Disease Activity Score in 28 joints (DAS28) and targeted treatments were collected. DAS28-based flare rates and categorised disease activity distribution prevaccination and post vaccination were analysed by log-linear regression and contingency analyses, respectively. The influence of vaccination on DAS28 variation as a continuous measure was evaluated using a random coefficient model.Results The distribution of categorised disease activity and flare rates was not significantly modified by vaccination. Log-linear regression showed no significant changes in the rate of flares in the 6-month period after vaccination compared with the same period prior to vaccination in neither patients with RA nor patients with PsA. When DAS28 variations were analysed using random coefficient models, no significant variations in disease activity were detected after vaccination for both groups of patients. However, patients with RA treated with Janus kinase inhibitors (JAK-i) (1) and interleukin-6 inhibitor (IL-6-i) experienced a worsening of disease activity (1.436±0.531, p=0.007, and 1.201±0.550, p=0.029, respectively) in comparison with those treated with tumour necrosis factor inhibitor (TNF-i). Similarly, patients with PsA treated with interleukin-12/23 inhibitor (IL-12/23-i) showed a worsening of disease activity (4.476±1.906, p=0.019) compared with those treated with TNF-i.Conclusion COVID-19 vaccination was not associated with increased rate of flares in patients with RA and PsA. However, a potential increase in disease activity in patients with RA treated with JAK-i and IL-6-i and in patients with PsA treated with IL-12/23-i warrants further investigation.
