Rheumatology Unit, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, and PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.
Rheumatology Unit, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy.
Clin Exp Rheumatol. 2023 Apr;41(4):787-791. doi: 10.55563/clinexprheumatol/ldv88a. Epub 2022 Jul 19.
Mixed cryoglobulinaemic vasculitis (MCV) is an immune-complex-mediated systemic vasculitis characterised by heterogeneous clinical manifestations mainly involving lymphatic system, skin, kidney and peripheral nervous system. Although MCV patients have been included in priority programs for vaccination against SARS-CoV-2 in Italy, limited information is available for these patients. The aims of this multicentre Italian study were to investigate SARS-CoV-2 vaccination rate in MCV patients and its safety profile.
All MCV patients referring to participating centres were assessed with an interview-based survey about vaccination, reasons for not getting vaccinated, adverse events (AE), and disease flares within a month after vaccination.
A total of 416 patients were included in the study. Among participants, 7.7% did not get vaccinated, mainly for fear related to vaccine side-effects (50%) or medical decision (18.8%). They were more frequently treated with chronic glucocorticoids or rituximab (p=0.049 and p=0.043, respectively). Mild and self-limiting AE were recorded in 31.7% of cases, while post-vaccination vasculitis flares were observed in 5.3% of subjects. Disease relapses were mainly observed in patients with peripheral neuropathy or skin vasculitis (40% and 25%, respectively).
Vaccination against SARS-CoV-2 has been performed in a high percentage of MCV patients with encouraging safety profile. Vasculitis flares rate was in line with that observed for other autoimmune diseases, despite patients with purpura or peripheral neuropathy seem to be at risk for symptoms' exacerbation. Patients' hesitancy, rituximab and glucocorticoids treatment were the main reasons for delaying vaccination.
混合性冷球蛋白血症性血管炎（MCV）是一种免疫复合物介导的系统性血管炎，其特征为异质性临床表现，主要涉及淋巴系统、皮肤、肾脏和周围神经系统。尽管意大利已将 MCV 患者纳入 SARS-CoV-2 疫苗接种优先计划，但针对这些患者的信息有限。本多中心意大利研究旨在调查 MCV 患者 SARS-CoV-2 疫苗接种率及其安全性。
所有转诊至参与中心的 MCV 患者均通过访谈式调查评估其疫苗接种情况、未接种疫苗的原因、接种后一个月内的不良反应（AE）和疾病发作情况。
本研究共纳入 416 例患者。在参与者中，7.7%的患者未接种疫苗，主要是因为担心疫苗副作用（50%）或医疗决策（18.8%）。他们更常接受慢性糖皮质激素或利妥昔单抗治疗（p=0.049 和 p=0.043）。31.7%的病例记录到轻微且自限性的 AE，而 5.3%的患者观察到接种后血管炎发作。疾病复发主要发生在有周围神经病或皮肤血管炎的患者中（分别为 40%和 25%）。
MCV 患者对 SARS-CoV-2 疫苗接种的接受率较高，且安全性良好。尽管有紫癜或周围神经病的患者似乎有症状加重的风险，但血管炎发作率与其他自身免疫性疾病观察到的一致。患者的犹豫、利妥昔单抗和糖皮质激素治疗是延迟接种的主要原因。
