No Increase in Rheumatoid Arthritis Flare After COVID-19 Vaccination

Patients with rheumatoid arthritis are not at increased risk of disease flares when they receive full COVID-19 vaccinations, say study results published online ahead of print in the Annals of the Rheumatic Diseases.

“Findings from this study provide real-world evidence of COVID-19 vaccine safety and could potentially overcome vaccine hesitancy among patients with rheumatoid arthritis,” researchers wrote.

The study included 5493 patients with rheumatoid arthritis in Hong Kong. Researchers used electronic medical record data to compare arthritis flare—defined as hospitalization and outpatient consultation relative to rheumatoid arthritis or reactive arthritis—among 653 patients who received full mRNA vaccination, 671 patients who received full vaccination with an inactive virus vaccine, and 4169 patients who were not vaccinated. To complement findings from the diagnosis-based analysis, they also looked at weekly prescriptions for rheumatic medication after the launch of COVID-19 vaccines.

Study results showed no significant association between arthritis flare and COVID-19 vaccination. Researchers reported adjusted incidence ratios of 0.86 with full mRNA vaccination and 0.87 with full inactive virus vaccination.

Furthermore, weekly prescription trends for major rheumatic medications after the launch of mass vaccination did not differ significantly among patients who received the mRNA vaccine, the inactive virus vaccine, or no vaccine.

Researchers noted that few patients in the study population were using corticosteroids, indicating that most were in the maintenance stage of rheumatic arthritis with stable disease or were in remission. Consequently, study findings may not be generalizable to patients with active rheumatoid arthritis.

“Real-world COVID-19 vaccine safety surveillance should continue to provide more robust evidence on the association between arthritis flare and COVID-19 vaccines,” researchers advised, “with direct disease activity tests and consideration of immunomodulated medications.”

—Jolynn Tumolo

Reference:
Li X, Tong X, Yeung WWY, et al. Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong. Ann Rheum Diseases. October 22, 2021;[Epub ahead of print].