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Rosenbaum JT, Weisman MH, Hamilton H, Shafer C, Aslanyan E, Howard RA, Ogle K, Reveille JD, Winthrop KL, Choi D. The Interplay Between COVID-19 and Spondyloarthritis or Its Treatment. J Rheumatol 2021; 49:225-229. [PMID: 34599048 DOI: 10.3899/jrheum.210742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has created multiple uncertainties regarding rheumatic diseases or their treatment, with regard to the susceptibility to or severity of the viral disease. We aimed to address these questions as they relate to spondyloarthritis (SpA). METHODS We created a longitudinal survey from April 10, 2020, to April 26, 2021. There were 4723 subjects with SpA and 450 household contacts who participated worldwide. Of these, 3064 respondents were from the US and 70.4% of them provided longitudinal data. To control for the duration of potential risk of COVID-19, the rate of contracting the disease was normalized for person-months of exposure. RESULTS In an analysis of US subjects who provided longitudinal data, the incident rate ratio for the 159 (out of 2157) subjects who tested positive for COVID-19 was 1.16 compared to the US population as adjusted for age and sex (range 0.997-1.361, P = 0.06). A paired evaluation using patients and household members did not show a statistically significant effect to indicate a predisposition for developing COVID-19 as a result of SpA or its treatment. Our data failed to show that any class of medication commonly used to treat SpA significantly affected the risk of developing COVID-19 or increasing the severity of COVID-19. CONCLUSION These data do not exclude a small increased risk of developing COVID-19 as a result of SpA, but the risk, if it exists, is low and not consistently demonstrated. The data should provide reassurance to patients and to rheumatologists about the risk that COVID-19 poses to patients with SpA.
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Affiliation(s)
- James T Rosenbaum
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Michael H Weisman
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Hedley Hamilton
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Cassie Shafer
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Elin Aslanyan
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Richard A Howard
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Kimberly Ogle
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - John D Reveille
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Kevin L Winthrop
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
| | - Dongseok Choi
- This work was supported by the Spondylitis Association of America and Any-3. The Spondylitis Association of America receives support from AbbVie for this project. AbbVie played no role in the study design, data interpretation, or writing of the results. JTR receives support from the Grandmaison Fund for Autoimmunity Research, the William and Mary Bauman Foundation, the Stan and Madelle Rosenfeld Family Trust, and Research to Prevent Blindness. J.T. Rosenbaum, MD, Departments of Medicine, Ophthalmology, and Cell Biology Oregon Health & Science University, and Legacy Devers Eye Institute, Portland, Oregon, USA; M.H. Weisman, MD, Cedars Sinai Medical Center, Los Angeles, California, USA; H. Hamilton, BSc, Any-3, London, UK; C. Shafer, BS, E. Aslanyan, BA, R.A. Howard, BA, Spondylitis Association of America, Los Angeles, California, USA; K. Ogle, BA, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, Portland, Oregon, USA; J.D. Reveille, MD, Department of Medicine, University of Texas, Houston, Texas, USA; K.L Winthrop, MD, MPH, D. Choi, PhD, OHSU-PSU School of Public Health and Departments of Medicine and Ophthalmology, Oregon Health & Science University, Portland, Oregon, USA. JTR consults for AbbVie, Gilead, UCB, Novartis, Roche, Horizon, Santen, Eyevensys, Corvus, Affibody, Revolo, Roivant, and Neoleukin; receives royalties from UpToDate; and receives grant support from Pfizer and Horizon. JTR serves on a data monitoring committee for Celgene (BMS). HH owns Any-3, the website that hosted the survey and donated its services. RAH owns stock in AbbVie, Amgen, BMS, GSK, Johnson and Johnson, Lilly, Merck, Novartis, Pfizer, and Teva. MHW consults for Novartis, UCB, Gilead, and GSK. JDR consults for UCB; and receives research support from Lilly and Janssen. KLW consults for Pfizer, AbbVie, UCB, Lilly, Galapagos, GSK, Roche, and Gilead; and receives research support from BMS and Pfizer. CS, EA, and RAH are employed by the Spondylitis Association of America. DC and KO report no conflicts of interest relevant to this article. Address correspondence to Dr. J.T. Rosenbaum, Departments of Medicine, Ophthalmology, and Cell Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., L467Ad Portland, OR 97239, USA. . Accepted for publication September 23, 2021
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Sattui SE, Liew JW, Kennedy K, Sirotich E, Putman M, Moni TT, Akpabio A, Alpízar-Rodríguez D, Berenbaum F, Bulina I, Conway R, Singh AD, Duff E, Durrant KL, Gheita TA, Hill CL, Howard RA, Hoyer BF, Hsieh E, El Kibbi L, Kilian A, Kim AH, Liew DFL, Lo C, Miller B, Mingolla S, Nudel M, Palmerlee CA, Singh JA, Singh N, Ugarte-Gil MF, Wallace J, Young KJ, Bhana S, Costello W, Grainger R, Machado PM, Robinson PC, Sufka P, Wallace ZS, Yazdany J, Harrison C, Larché M, Levine M, Foster G, Thabane L, Rider LG, Hausmann JS, Simard JF, Sparks JA. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. RMD Open 2021; 7:e001814. [PMID: 34493645 PMCID: PMC8424419 DOI: 10.1136/rmdopen-2021-001814] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We describe the early experiences of adults with systemic rheumatic disease who received the COVID-19 vaccine. METHODS From 2 April to 30 April 2021, we conducted an online, international survey of adults with systemic rheumatic disease who received COVID-19 vaccination. We collected patient-reported data on clinician communication, beliefs and intent about discontinuing disease-modifying antirheumatic drugs (DMARDs) around the time of vaccination, and patient-reported adverse events after vaccination. RESULTS We analysed 2860 adults with systemic rheumatic diseases who received COVID-19 vaccination (mean age 55.3 years, 86.7% female, 86.3% white). Types of COVID-19 vaccines were Pfizer-BioNTech (53.2%), Oxford/AstraZeneca (22.6%), Moderna (21.3%), Janssen/Johnson & Johnson (1.7%) and others (1.2%). The most common rheumatic disease was rheumatoid arthritis (42.3%), and 81.2% of respondents were on a DMARD. The majority (81.9%) reported communicating with clinicians about vaccination. Most (66.9%) were willing to temporarily discontinue DMARDs to improve vaccine efficacy, although many (44.3%) were concerned about rheumatic disease flares. After vaccination, the most reported patient-reported adverse events were fatigue/somnolence (33.4%), headache (27.7%), muscle/joint pains (22.8%) and fever/chills (19.9%). Rheumatic disease flares that required medication changes occurred in 4.6%. CONCLUSION Among adults with systemic rheumatic disease who received COVID-19 vaccination, patient-reported adverse events were typical of those reported in the general population. Most patients were willing to temporarily discontinue DMARDs to improve vaccine efficacy. The relatively low frequency of rheumatic disease flare requiring medications was reassuring.
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Affiliation(s)
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kevin Kennedy
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Emily Sirotich
- Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael Putman
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Tarin T Moni
- Department of Biochemistry & Biomedical Sciences, McMaster University Faculty of Science, Hamilton, Ontario, Canada
| | - Akpabio Akpabio
- Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | | | - Inita Bulina
- Department of Internal Diseases, Rheumatology Centre, Paul Stradins Clinical University Hospital, Riga, Latvia
| | | | | | - Eimear Duff
- Department of Rheumatology, Saint James's Hospital, Dublin, Ireland
| | | | - Tamer A Gheita
- Rheumatology and Clinical Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Catherine L Hill
- Rheumatology Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Bimba F Hoyer
- Medical Department I, Department for Rheumatology and Clinical Immunology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Schleswig-Holstein, Germany
| | - Evelyn Hsieh
- Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, Connecticut, USA
- Section of Rheumatology, VA Connecticut Healthcare System-West Haven Campus, West Haven, Connecticut, USA
| | - Lina El Kibbi
- Rheumatology, Specialized Medical Center Hospital, Riyadh, Saudi Arabia
| | - Adam Kilian
- Department of Internal Medicine, Division of Rheumatology, Saint Louis University, Saint Louis, Missouri, USA
| | - Alfred Hyoungju Kim
- Medicine/Rheumatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
| | - David F L Liew
- Rheumatology, Austin Health, Heidelberg West, Victoria, Australia
- Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg, Victoria, Australia
| | - Chieh Lo
- I-Shou University College of Medicine, Yanchau Sheng, Taiwan
| | - Bruce Miller
- Medicine, University of California San Diego, La Jolla, California, USA
| | - Serena Mingolla
- Italian National Patient Association for Rehumatoid and Rare Disease (APMARR), Rome, Italy
| | - Michal Nudel
- The Israeli Association for RMD Patients "Mifrakim Tz'eirim", Haifa, Israel
| | - Candace A Palmerlee
- Relapsing Polychondritis Foundation, International Relapsing Polychondritis Research Network, Walnut Creek, California, USA
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Namrata Singh
- Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA
| | - Manuel Francisco Ugarte-Gil
- Department of Rheumatology, Universidad Cientifica del Sur, Lima, Peru
- Universidad Científica del Sur, Lima, Peru
| | | | - Kristen J Young
- Division of Rheumatology, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | | | - Wendy Costello
- Irish Children's Arthritis Network (iCAN), Tipperary, Ireland
| | - Rebecca Grainger
- Department of Medicine, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Pedro M Machado
- MRC Centre for Neuromuscular Diseases, University College London, London, UK
- Rheumatology, University College London Centre for Rheumatology, London, UK
| | - Philip C Robinson
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Metro North Hospital & Health Service, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia
| | | | - Zachary S Wallace
- Clinical Epidemiology Program and Rheumatology Unit, Division of Rheumatology,Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jinoos Yazdany
- Medicine/Rheumatology, University of California, San Francisco, California, USA
| | | | - Maggie Larché
- Division of Clinical Immunology and Allergy, McMaster University Department of Medicine, Hamilton, Ontario, Canada
| | - Mitchell Levine
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gary Foster
- Department of Health Research Methods, Evidence, and Impact (HEI); Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Lisa G Rider
- Environmental Autoimmunity Group, NIEHS/NIH/DHHS, Bethesda, Maryland, USA
| | - Jonathan S Hausmann
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA
- Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Julia F Simard
- Epidemiology and Population Health and Department of Medicine, Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA
- Department of Medicine, Clinical Epidemiology Unit, Sweden
| | - Jeffrey A Sparks
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
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