Gor Shivani, Kim Sung-Hee, Yein Khin, Michael Jessica, Price Elizabeth
Department of Rheumatology, Great Western Hospital, Swindon, UK.
Rheumatol Adv Pract. 2023 Mar 24;7(Suppl 1):i2-i5. doi: 10.1093/rap/rkad005. eCollection 2023 Apr.
The aim was to determine the proportion of patients with inflammatory arthritis who have a flare of their rheumatological disease within 4 weeks of receiving a coronavirus disease 2019 (COVID-19) vaccine, using CRP as a surrogate marker.
A retrospective review was conducted of notes for patients with inflammatory arthritis within 30 days of their COVID-19 vaccine. An electronic database (DAWN) was used to identify all patients who were currently on a DMARD or biologic therapy. This was then correlated with vaccine data from the National Immunisation and Vaccination System (NIVS) and CRP within 30 days of their vaccination.
From the DAWN database, 1620 adults were identified (mean age 61 years, 64% female). Three types of vaccinations were administered: AstraZeneca (AZ), BioNTech-Pfizer or Moderna. Vaccine uptake was 1542 of 1620 (95.2% for the first dose), 1550 of 1620 (95.7% for the second dose) and 1437 of 1620 (88.7% for the third dose). One hundred and ninety-two of 1542 patients (12.5%) had a CRP rise of >10 mg/l within 30 days of their vaccine, which was higher than the baseline flare rate of 8.6% ( = 0.0004).
Patients with inflammatory arthritis and on DMARDs have a high uptake of COVID-19 vaccine (95%), which is greater than the national average. A CRP rise >10 mg/l within 30 days of vaccination was observed in ∼1 in 10 patients in our study population after all three doses. There might be a slight increase in disease flare in patients with inflammatory arthritis after COVID-19 vaccinations, and additional research is required to assess this association further.
以C反应蛋白（CRP）作为替代标志物，确定在接种2019冠状病毒病（COVID-19）疫苗后4周内出现风湿性疾病病情复发的炎性关节炎患者比例。
对炎性关节炎患者在接种COVID-19疫苗后30天内的病历进行回顾性研究。使用电子数据库（DAWN）识别所有正在接受改善病情抗风湿药（DMARD）或生物疗法的患者。然后将这些信息与国家免疫和疫苗接种系统（NIVS）的疫苗数据以及接种疫苗后30天内的CRP进行关联分析。
从DAWN数据库中，共识别出1620名成年人（平均年龄61岁，64%为女性）。共接种了三种类型的疫苗：阿斯利康（AZ）、辉瑞BioNTech或莫德纳。疫苗接种率分别为：1620人中的1542人（首剂接种率95.2%）、1620人中的1550人（第二剂接种率95.7%）和1620人中的1437人（第三剂接种率88.7%）。1542名患者中有192人（12.5%）在接种疫苗后30天内CRP升高超过10mg/l，高于8.6%的基线病情复发率（P=0.0004）。
患有炎性关节炎且正在接受DMARD治疗的患者对COVID-19疫苗的接种率较高（95%），高于全国平均水平。在我们的研究人群中，所有三剂疫苗接种后，约每10名患者中有1名在接种疫苗后30天内CRP升高超过10mg/l。COVID-19疫苗接种后，炎性关节炎患者的疾病病情复发可能会略有增加，需要进一步的研究来评估这种关联。
