Flares in idiopathic inflammatory myopathies (IIMs) and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys
Authors' conclusion
A diagnosis of IIMs confers an equal risk of flares in the post-COVID-19 vaccination period to AIRDs, with active disease, female gender and comorbidities conferring a higher risk.
Study context
- Population
- Respondents to the COVAD-1 (early 2021) and COVAD-2 (early 2022) global surveys with IIMs or other autoimmune rheumatic diseases (AIRDs), post-COVID-19 vaccination; IIMs age 63 years, 70.3% female, 80.8% Caucasians15,165 total respondents
- Participants
- 1,278 vs 3,453
- Exposure
- IIMs vs other AIRDs; risk factors of flares after COVID-19 vaccination
- IIMsn = 1,278
- AIRDsn = 3,453reference
- Outcome
- Flares of IIMs after COVID-19 vaccination, defined as (a) patient self-reported, (b) IS denoted, (c) clinical sign directed, (d) >7.9-point MCID worsening of PROMIS PF10a score
Methodological detailscombined analysis of the COVAD-1 and −2 global surveys, regression models
- Combined analysis of the COVAD-1 and −2 global surveys
- Regression models
Main finding
As reported in the abstract
Flares of IIM by definitions (a) to (d)
- (a) patient self-reported
- 9.6%
- (b) immunosuppression (IS) denoted
- 12.7%
- (c) clinical sign directed
- 8.7%
- (d) Patient-Reported Outcomes Measurement Information System (PROMIS) PF10a worsening
- 19.6%
- Median time to flare, days (similar to AIRDs)
- 71.5 (10.7-235)
Observational data: associations, not effects.
Further findings
Risk factors for flares (pre-vaccination disease activity and immunosuppressants)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Active IIM pre-vaccination | 1.2 (1.03–1.6) | P = 0.025 | |
| Rituximab | 0.3 (0.1–0.7) | P = 0.010 | |
| AZA | 0.3 (0.1–0.8) | P = 0.016 | |
| 0.10.31310Odds ratio (log scale) |
Disparity between self-reported and IS-denoted flares
| OR (95% CI) | P value | ||
|---|---|---|---|
| Asthma | 1.62 (1.05–2.50) | P = 0.028 | |
| Higher pain visual analogue score | 1.19 (1.11–1.27) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Risk factors for flares (pre-vaccination disease activity and immunosuppressants)
- Female gender and comorbidities predisposed to flares requiring changes in IS
Original publication
Flares in IIMs and the timeline following COVID-19 vaccination: a combined analysis of the COVAD-1 and -2 surveys. Rheumatology (Oxford). Published 21 April 2023. doi:10.
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