Flare and change in disease activity among patients with stable rheumatoid arthritis following coronavirus disease 2019 vaccination:A prospective Chinese cohort study  

作　　者：Yan Geng Yong Fan Yu Wang Xuerong Deng Lanlan Ji Xiaohui Zhang Zhibo Song Hong Huang Yanni Gui Haoze Zhang Xiaoying Sun Guangtao Li Juan Zhao Zhuoli Zhang 

机构地区：[1]Department of Rheumatology and Clinical Immunology,Peking University First Hospital,Beijing 100034,China

出　　处：《Chinese Medical Journal》2023年第19期2324-2329,共6页中华医学杂志（英文版）

基　　金：supported by grants from the National Natural Science Foundation of China(Nos.81771740,81901646);Interdisciplinary Clinical Research Project of Peking University First Hospital(No.2021CR30);Peking University Medicine Seed Fund for Interdisciplinary Research supported by the Fundamental Research Funds for the Central Universities(No.BMU2022MX003)

摘　　要：Background:Vaccination has been shown effective in controlling the global coronavirus disease 2019(COVID-19)pandemic and reducing severe cases.This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis(RA).Methods:A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status.Each of them was examined every 3 to 6 months.In the vaccination group,disease activity was compared before and after vaccination.The rates of flare defined as disease activity scores based on 28-joint count(DAS28)>3.2 withΔDAS28≥0.6 were compared between vaccination and non-vaccination groups.Results:A total of 202 eligible RA patients were enrolled.Of these,98 patients received no vaccine shot(non-vaccination group),and 104 patients received two doses of vaccine(vaccination group).The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days,respectively.The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar.At enrollment,gender,RA disease course,seropositivity,and disease activity were comparable across the two groups.Flare was observed in five(4.8%)of the vaccination group patients and nine(9.2%)of the non-vaccination group patients at post-vaccination assessment(P=0.221).In terms of safety,29(27.9%)patients experienced adverse events(AEs)after vaccination.No serious AEs occurred.Conclusions:COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity.Patients with stable RA should be encouraged to receive the COVID-19 vaccination.

关 键 词：COVID-19 vaccination Rheumatoid arthritis Disease activity FLARE Adverse events 

分 类 号：R593.22[医药卫生—内科学] R183[医药卫生—临床医学]