Louthrenoo Worawit, Tangkum Punsita, Kasitanon Nuntana, Gumtorntip Wanitcha, Winichakoon Poramed, Konsamun Supparat, Wongthanee Antika
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Vaccines (Basel). 2024 Dec 12;12(12):1399. doi: 10.3390/vaccines12121399.
: To compare disease activity and flares among different doses and types of COVID-19 vaccines in systemic lupus erythematosus (SLE) patients. SLE patients in a lupus cohort, who received at least one dose of a COVID-19 vaccine (inactivated virus, adenovirus-vectored, or mRNA vaccines) between March and October 2022 joined this study. The data regarding disease activity and flares after each dose were reviewed and compared. Two hundred and one SLE patients (524 total doses) were included in this study, with 201, 199, and 124 of them receiving 1, 2, and 3 doses of a vaccine, respectively, which comprised 183, 128, and 213 doses of inactivated virus, adenovirus-vectored, and mRNA vaccines, respectively. Regardless of vaccine dose or type, there were no significant changes in SLE disease activity pre- or post-vaccination. Flares were significantly more common after the 2nd and 3rd doses than after the 1st one (20.10% and 17.74% vs. 8.96%, = 0.001, and = 0.010, respectively), and after inactivated virus, adenovirus-vectored and mRNA vaccinations in 11.48%, 14.84%, and 17.84% of the patients ( = ns), respectively. However, the incidence rate of flares/100 patient-months was not different. The majority of flares were severe, with renal flares being the most frequent. Renal and mucocutaneous involvement and high SLE disease activity prior to the 1st vaccine dose were independent factors that predicted flares. Flares after COVID-19 vaccination were not uncommon. Most of the flares were severe, mainly due to renal flares. SLE patients should have stable low disease activity prior to receiving COVID-19 vaccine in order to avoid flares.
比较不同剂量和类型的新冠疫苗在系统性红斑狼疮（SLE）患者中的疾病活动度和病情复发情况。狼疮队列中的SLE患者在2022年3月至10月期间接受了至少一剂新冠疫苗（灭活病毒疫苗、腺病毒载体疫苗或mRNA疫苗），并参与了本研究。对每次接种疫苗后疾病活动度和病情复发的数据进行了回顾和比较。本研究纳入了201例SLE患者（共524剂疫苗），其中分别有201例、199例和124例患者接种了1剂、2剂和3剂疫苗，分别包括183剂、128剂和213剂灭活病毒疫苗、腺病毒载体疫苗和mRNA疫苗。无论疫苗剂量或类型如何，接种疫苗前后SLE疾病活动度均无显著变化。第2剂和第3剂疫苗接种后的病情复发明显比第1剂后更常见（分别为20.10%和17.74% 对比8.96%，P = 0.001和P = 0.010），灭活病毒疫苗、腺病毒载体疫苗和mRNA疫苗接种后病情复发的患者分别为11.48%、14.84%和17.84%（P = 无显著差异）。然而，每100患者月的病情复发发生率并无差异。大多数病情复发较为严重，其中肾脏复发最为常见。首次接种疫苗前的肾脏和皮肤黏膜受累以及高SLE疾病活动度是预测病情复发的独立因素。新冠疫苗接种后的病情复发并不罕见。大多数病情复发较为严重，主要是由于肾脏复发。SLE患者在接种新冠疫苗前应具有稳定的低疾病活动度，以避免病情复发。
