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类风湿关节炎患者中与新冠病毒疫苗接种相关的延迟不良事件:国际COVAD调查结果

COVID-19 vaccination-related delayed adverse events among people with rheumatoid arthritis: results from the international COVAD survey.

作者信息

Dey Mrinalini, Doskaliuk Bohdana, Parodis Ioannis, Lindblom Julius, Wincup Chris, Joshi Mrudula, Dey Dzifa, Katchamart Wanruchada, Kadam Esha, Sen Parikshit, Shinjo Samuel Katsuyuki, Nune Arvind, Goo Phonpen Akarawatcharangura, Ziade Nelly, Chen Yi Ming, Traboco Lisa S, Gutiérrez Carlos Enrique Toro, Vaidya Binit, Agarwal Vikas, Gupta Latika, Nikiphorou Elena

机构信息

Centre for Rheumatic Diseases, King's College London, London, UK.

Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.

出版信息

Rheumatol Int. 2024 Dec;44(12):2853-2861. doi: 10.1007/s00296-024-05742-x. Epub 2024 Nov 6.

Abstract

This study aimed to assess COVID-19 vaccination-related AEs in patients with rheumatoid arthritis (RA), in the COVID-19 Vaccination in Autoimmune Diseases (COVAD)-2 study. An online international cross-sectional survey captured self-reported data on COVID-19 vaccination-related adverse events (AEs) in people with RA, autoimmune diseases (AIDs; rheumatic [r] and non-rheumatic [nr]) and healthy controls (HCs). The survey was circulated by the COVAD study group, comprising 157 collaborators across 106 countries, from February to June 2022. Delayed AEs among RA were compared with other rAIDs, nrAIDs and HCs using multivariable binary regression. A total of 7203 participants were included (1423 [19.7%] RA, 2620 [36.4%] rAIDs, 426 [5.9%] nrAIDs, 2734 [38%] HCs), with 75% female. Compared to HCs, individuals with RA reported higher overall major AEs [OR 1.3 (1.0-1.7)], and an increased number of several minor AEs. Compared to nrAIDs, people with RA had several increased reported minor AEs including myalgia and joint pain. People with active RA had increased major AEs [OR 1.8 (1.1-3.0)] and hospitalisation [OR 4.1 (1.3 - 13.3)] compared to inactive RA. RA patients without autoimmune comorbidities had significantly fewer major and minor AEs than those with other rAIDs. A decreased incidence of hospitalisation was seen in patients taking methotrexate or TNF inhibitors compared to patients not taking these medications. COVID-19 vaccination is associated with minimal to no risks of delayed AEs in patients with RA compared to HCs, and fewer compared to other rAIDs. Active RA and presence of co-existing rAIDs were associated with an increased risk of delayed AEs.

摘要

在自身免疫性疾病COVID-19疫苗接种(COVAD)-2研究中,本研究旨在评估类风湿性关节炎(RA)患者中与COVID-19疫苗接种相关的不良事件(AE)。一项在线国际横断面调查收集了RA患者、自身免疫性疾病(AID;风湿性[r]和非风湿性[nr])患者及健康对照(HC)中与COVID-19疫苗接种相关不良事件的自我报告数据。该调查由COVAD研究小组于2022年2月至6月发布,该小组由来自106个国家的157名合作者组成。使用多变量二元回归比较RA患者中的延迟不良事件与其他风湿性自身免疫性疾病、非风湿性自身免疫性疾病及健康对照。共纳入7203名参与者(1423名[19.7%]RA患者、2620名[36.4%]风湿性自身免疫性疾病患者、426名[5.9%]非风湿性自身免疫性疾病患者、2734名[38%]健康对照),其中75%为女性。与健康对照相比,RA患者报告的总体严重不良事件更高[比值比(OR)1.3(1.0 - 1.7)],且多种轻微不良事件的数量增加。与非风湿性自身免疫性疾病患者相比,RA患者报告的多种轻微不良事件增加,包括肌痛和关节疼痛。与非活动期RA患者相比,活动期RA患者的严重不良事件[OR 1.8(1.1 - 3.0)]和住院率[OR 4.1(1.3 - 13.3)]更高。与患有其他风湿性自身免疫性疾病的患者相比,无自身免疫性合并症的RA患者的严重和轻微不良事件明显更少。与未服用这些药物的患者相比,服用甲氨蝶呤或肿瘤坏死因子抑制剂的患者住院率降低。与健康对照相比,RA患者中与COVID-19疫苗接种相关的延迟不良事件风险极小或无风险,与其他风湿性自身免疫性疾病患者相比风险更低。活动期RA和并存的风湿性自身免疫性疾病与延迟不良事件风险增加相关。

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Rheumatology (Oxford). 2023 Dec 1;62(12):3838-3848. doi: 10.1093/rheumatology/kead144.
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Efficacy and safety of COVID-19 vaccines.
Cochrane Database Syst Rev. 2022 Dec 7;12(12):CD015477. doi: 10.1002/14651858.CD015477.
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Rheumatology (Oxford). 2023 Jul 5;62(7):2453-2463. doi: 10.1093/rheumatology/keac661.
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Rheumatology (Oxford). 2023 Jul 5;62(7):2366-2376. doi: 10.1093/rheumatology/keac624.
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COVAD survey 2 long-term outcomes: unmet need and protocol.
Rheumatol Int. 2022 Dec;42(12):2151-2158. doi: 10.1007/s00296-022-05157-6. Epub 2022 Aug 14.

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