TY - JOUR
T1 - Disease activity in patients with immune-mediated inflammatory diseases after SARS-CoV-2 vaccinations
AU - van Dam, Koos P.J.
AU - Wieske, Luuk
AU - Stalman, Eileen W.
AU - Kummer, Laura Y.L.
AU - Roosen, Jesse
AU - van Kempen, Zoé L.E.
AU - Killestein, Joep
AU - Volkers, Adriaan G.
AU - Boekel, Laura
AU - Wolbink, Gerrit J.
AU - van der Kooi, Anneke J.
AU - Raaphorst, Joost
AU - Löwenberg, Mark
AU - Takkenberg, R. Bart
AU - D'Haens, Geert R.A.M.
AU - Spuls, Phyllis I.
AU - Bekkenk, Marcel W.
AU - Musters, Annelie H.
AU - Post, Nicoline F.
AU - Bosma, Angela L.
AU - Hilhorst, Marc L.
AU - Vegting, Yosta
AU - Bemelman, Frederike J.
AU - Voskuyl, Alexandre E.
AU - Broens, Bo
AU - Sanchez, Agner Parra
AU - van Els, Cécile A.C.M.
AU - de Wit, Jelle
AU - Rutgers, Abraham
AU - de Leeuw, Karina
AU - Horváth, Barbara
AU - Verschuuren, Jan J.G.M.
AU - Ruiter, Annabel M.
AU - van Ouwerkerk, Lotte
AU - van der Woude, Diane
AU - Allaart, Renée C.F.
AU - Teng, Y. K.Onno
AU - van Paassen, Pieter
AU - Busch, Matthias H.
AU - Jallah, Papay B.P.
AU - Brusse, Esther
AU - van Doorn, Pieter A.
AU - Baars, Adája E.
AU - Hijnen, Dirk Jan
AU - Schreurs, Corine R.G.
AU - van der Pol, W. Ludo
AU - Goedee, H. Stephan
AU - Steenhuis, Maurice
AU - van Ham, S.M.
AU - Verstegen, Niels J.M.
AU - Tas, Sander W.
N1 - Publisher Copyright: © 2022
PY - 2023/2
Y1 - 2023/2
N2 - For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine. Patients reported changes in disease activity on a five-point Likert scale every 60 days for up to twelve months after first vaccination. In case of self-reported increased activity, hospital records were screened whether the treating physician reported increased activity, and for potential intensification of immunosuppressive (ISP) treatment. Mixed models were used to study determinants for self-reported increased disease activity. In total, 2111 patients were included for analysis after primary immunization (mean age 49.7 years [SD 13.7], 1329/2111 (63.0%) female), from which 1266 patients for analysis after first additional vaccination. Increased disease activity at 60 days after start of primary immunization was reported by 223/2111 (10.6%). In 96/223 (43.0%) the increase was confirmed by the treating physician and in 36/223 (16.1%) ISP treatment was intensified. Increased disease activity at seven to 60 days after additional vaccination, was reported by 139/1266 (11.0%). Vaccinations were not temporally associated with self-reported increased disease activity. Conversely, increased disease activity before first vaccination, neuromuscular disease, and multiple sclerosis were associated. Altogether, self-reported increased disease activity after vaccination against SARS-CoV-2 was recorded in a minority of patients and was generally mild. Moreover, multivariate analyses suggest that disease related factors, but not vaccinations are the major determinants for self-reported increased disease activity.
AB - For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine. Patients reported changes in disease activity on a five-point Likert scale every 60 days for up to twelve months after first vaccination. In case of self-reported increased activity, hospital records were screened whether the treating physician reported increased activity, and for potential intensification of immunosuppressive (ISP) treatment. Mixed models were used to study determinants for self-reported increased disease activity. In total, 2111 patients were included for analysis after primary immunization (mean age 49.7 years [SD 13.7], 1329/2111 (63.0%) female), from which 1266 patients for analysis after first additional vaccination. Increased disease activity at 60 days after start of primary immunization was reported by 223/2111 (10.6%). In 96/223 (43.0%) the increase was confirmed by the treating physician and in 36/223 (16.1%) ISP treatment was intensified. Increased disease activity at seven to 60 days after additional vaccination, was reported by 139/1266 (11.0%). Vaccinations were not temporally associated with self-reported increased disease activity. Conversely, increased disease activity before first vaccination, neuromuscular disease, and multiple sclerosis were associated. Altogether, self-reported increased disease activity after vaccination against SARS-CoV-2 was recorded in a minority of patients and was generally mild. Moreover, multivariate analyses suggest that disease related factors, but not vaccinations are the major determinants for self-reported increased disease activity.
KW - Autoimmune disease
KW - COVID-19
KW - Disease activity
KW - Flare
KW - SARS-CoV-2
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85145851522&partnerID=8YFLogxK
U2 - 10.1016/j.jaut.2022.102984
DO - 10.1016/j.jaut.2022.102984
M3 - Article
C2 - 36621174
SN - 0896-8411
VL - 135
JO - Journal of autoimmunity
JF - Journal of autoimmunity
M1 - 102984
ER -