AB0088 OSTEOARTICULAR REACTIONS POST ANTI COVID-19 VACCINATION
Authors: N. EL Ouardi, H. Zouaki, E. A. Houda, L. Taoubane, H. Elhani, K. El Marbouh, A. Majjad, H. Toufik, A. Bezza
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Anti covid-19 vaccination is the one of the most effective interventions to substantially reduce severe disease and death due to SARS-CoV-2 infection. However, the side effects of anti covid- 19 vaccines are not well examinated in the extensive studies. Over the last three years, new-onset ostearticular reactions following anti covid-19 vaccines have been reported increasingly in both patients with and without history of chronic joint disease (CJD). Whether the association between anti covid-19 vaccine and osteoarticular manifestations is coincidental or causal remains to be elucidated. <h3>Objectives:</h3> The aim of our study was to analyze osteoarticular reactions in response to certain anti covid-19 vaccines in patients with CDJ (Rheumatoid Arthritis (RA) or Spondyloarthritis (SpA)) and patients without history of CJD. <h3>Methods:</h3> The inclusion period was from January to December 2023 and concerned patients over 18 years old followed for RA or SpA as well as patients without history of CJD. Data were selected from patients' medical records. <h3>Results:</h3> 148 patients were included, 71 patients with CJD (51 RA, 20 SpA) and 77 patients without history of CJD. Antecedent of covid-19 infection was reported in 25.4% patients with CJD and 11.7% patients without CJD. Antecedent of autoimmune disease was reported in 7% patients with CJD (2 autoimmune thyroiditis, 1 inflammatory bowel disease, 1 behcet and 1 familial antecedent of RA) and 5.1% patients without CJD (1 autoimmune thyroiditis, 1 inflammatory bowel disease, 1 rheumatoid arthritis, 1 lichen planus). At the first dose of anti covid-19 vaccine, all RA and SpA patients were in remission; the median of DAS28 CRP, BASDAI and ASDAS CRP were 0.6, 1.1 and 0.8 respectively. The antirheumatic treatments used were csDMARDs (57.7%), bDMARDs (33.8%), corticosteroids (45.1%) and NSAIDs (15.5%). No significant differences were found when comparing the prevalence of anti covid-19 vaccination between patients with and without CJD for the first 3 doses of vaccine (first dose: 94.4% versus 92.2%; second dose: 87.3% versus 87%; third dose: 52.1% versus 53.2%). When 15.5% patients with CJD had received the fourth dose, no patient without CJD had received the fourth dose. Astrazenica was the most common vaccine used in RA and SpA patients for the first and second dose (52.1% and 47.9% respectively). Synopharm was the most common vaccine used for the third and fourth dose (23.9% and 7% respectively). Synopharm was the most used vaccine in patients without CJD for the 4 doses (53.9%, 48.6%, 22.1% and 2.6% respectively). Fear of post-vaccinal reactions was the major cause of discontinuing the vaccination protocol in patients with and without CJD (first dose: 50%; second dose: 52.6%; third dose: 75.7%). 23 osteoarticular reaction following anti covid-19 vaccination have been reported in patients with CJD including 1 flare-up of SpA and 15 cases of non-specific arthralgia, 5 rachialgia, 2 diffuse myalgia. The evolution varied between remission and persistence. 14 cases of non-specific osteoarticular reactions (7 arthralgia, 5 rachialgia, 1 diffuse myalgia, 1 bilateral buttock pain) that resolved spontaneously and 1 erosive seronegative RA difficult to treat (refractory to bDMARDs and anti -JAK) have been reported in patients without CJD. In binary logistic regression, osteoarticular reactions were associated with age, sex and presence of CJD (p=0.002, p=0.001, p=0.002 respectively). No association were found with level of education, antecedent of covid-19 infection, antecedent of autoimmune disease (=0.10, p=0.82 and p=0.98 respectively). <h3>Conclusion:</h3> Our study is the first to evaluate osteoarticular reactions following anti covid-19 vaccination in Morocco. The post-vaccination surveillance programme and ongoing follow-up are warranted to ensure data collection on these associations to assess causality. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>