AB0227 FLARES AFTER SARS-CoV-2 VACCINATION IN PATIENTS WITH INFLAMMATORY ARTHRITIS: RESULTS OF A SINGLE CENTER
Authors: G. Vukatana, L. B. Boling, A. Carbone, M. Reta
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The SARS-CoV-2 outbreak was one of the most important public health crises in recent history. The global vaccination campaign was integral in the response to this pandemic, with multiple vaccine types being made available for the general public. Among these are those based on mRNA technology (Pfizer/BioN-Tech and Moderna), vaccines using replicating adenoviral vector that expressed the spike protein (AstraZeneca), and a non-replicating recombinant adenovirus that contains a full-length spike protein (Janssen). <h3>Objectives:</h3> The aim of this study is to investigate the incidence of flares after SARS-CoV-2 vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondyloarthritis (SpA). <h3>Methods:</h3> Patients in follow-up at the Rheumatology Unit of Azienda Ospedaliero Universitaria IRCCS Bologna Italy, affected by RA, PsA and SpA who had received at least one dose of a SARS-CoV-2 vaccine between January 2021 and December 2022 were enrolled. Every patient underwent a standard rheumatological visit which consisted in tender and swollen joint count as well as assessment of laboratory analyses and patient outcomes. Each patient was asked the type of SARS-CoV-2 vaccine that he or she received and the dates in which each dose was administered. The median number of doses received of the SASR-CoV-2 vaccine were 3. Disease activities were calculated based on specific European criteria for each specific disease. In the case of disease flares a musculoskeletal (MSK) ultrasound valuation was performed by using an Esaote My Lab 70 machine with linear probe 8-24 mHz and done by an expert MSK-US rheumatologist. The definition of "active" synovitis, tenosynovitis, or enthesitis by ultrasound evaluation was based on the OMERACT US definition. Data regarding the need for pharmacological treatment or modification of ongoing treatment were collected in case of flares. <h3>Results:</h3> 409 patients (F= 270) affected by RA, PsA, and SpA were enrolled in this study. Demographic data, disease distribution, and treatment information are shown in Table 1. Of the 409 patients, 350 (86%) received Pfizer-BioNTech (BNT162b2), 32 (7,6%) Oxford-AstraZeneca, 25 (6%) Moderna and 2 (0,4%) Jassen vaccines. One patient (0,2 %) reported a disease flare after the first dose and eight (1,9 %) after the second dose. Specific data of patients' flares are shown on Table 2. All flares were prescribed a cycle of corticosteroids with complete resolution of the flare, without additional treatment modification. The patients later underwent the 2<sup>nd</sup> and 3<sup>rd</sup> doses without additional flares. <h3>Conclusion:</h3> Our data suggest that flares are possible, but not frequent after SARS-CoV- 2 vaccination in patients affected by RA, PsA or SpA. The disease flares were almost all moderate and were resolved after a corticosteroid cycle, without DMARD treatment modification. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>