Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines

<b>Objectives</b>: To compare disease activity and flares among different doses and types of COVID-19 vaccines in systemic lupus erythematosus (SLE) patients. <b>Methods:</b> SLE patients in a lupus cohort, who received at least one dose of a COVID-19 vaccine (inactivated vir...

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Main Authors: Worawit Louthrenoo, Punsita Tangkum, Nuntana Kasitanon, Wanitcha Gumtorntip, Poramed Winichakoon, Supparat Konsamun, Antika Wongthanee
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/12/12/1399
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author Worawit Louthrenoo
Punsita Tangkum
Nuntana Kasitanon
Wanitcha Gumtorntip
Poramed Winichakoon
Supparat Konsamun
Antika Wongthanee
author_facet Worawit Louthrenoo
Punsita Tangkum
Nuntana Kasitanon
Wanitcha Gumtorntip
Poramed Winichakoon
Supparat Konsamun
Antika Wongthanee
author_sort Worawit Louthrenoo
collection DOAJ
description <b>Objectives</b>: To compare disease activity and flares among different doses and types of COVID-19 vaccines in systemic lupus erythematosus (SLE) patients. <b>Methods:</b> SLE patients in a lupus cohort, who received at least one dose of a COVID-19 vaccine (inactivated virus, adenovirus-vectored, or mRNA vaccines) between March and October 2022 joined this study. The data regarding disease activity and flares after each dose were reviewed and compared. <b>Results:</b> Two hundred and one SLE patients (524 total doses) were included in this study, with 201, 199, and 124 of them receiving 1, 2, and 3 doses of a vaccine, respectively, which comprised 183, 128, and 213 doses of inactivated virus, adenovirus-vectored, and mRNA vaccines, respectively. Regardless of vaccine dose or type, there were no significant changes in SLE disease activity pre- or post-vaccination. Flares were significantly more common after the 2nd and 3rd doses than after the 1st one (20.10% and 17.74% vs. 8.96%, <i>p</i> = 0.001, and <i>p</i> = 0.010, respectively), and after inactivated virus, adenovirus-vectored and mRNA vaccinations in 11.48%, 14.84%, and 17.84% of the patients (<i>p</i> = ns), respectively. However, the incidence rate of flares/100 patient-months was not different. The majority of flares were severe, with renal flares being the most frequent. Renal and mucocutaneous involvement and high SLE disease activity prior to the 1st vaccine dose were independent factors that predicted flares. <b>Conclusions:</b> Flares after COVID-19 vaccination were not uncommon. Most of the flares were severe, mainly due to renal flares. SLE patients should have stable low disease activity prior to receiving COVID-19 vaccine in order to avoid flares.
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publishDate 2024-12-01
publisher MDPI AG
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series Vaccines
spelling doaj-art-a212c0e3a8c7491c9edb490715ff57a32024-12-27T14:58:06ZengMDPI AGVaccines2076-393X2024-12-011212139910.3390/vaccines12121399Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 VaccinesWorawit Louthrenoo0Punsita Tangkum1Nuntana Kasitanon2Wanitcha Gumtorntip3Poramed Winichakoon4Supparat Konsamun5Antika Wongthanee6Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandResearch Unit, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandResearch Unit, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand<b>Objectives</b>: To compare disease activity and flares among different doses and types of COVID-19 vaccines in systemic lupus erythematosus (SLE) patients. <b>Methods:</b> SLE patients in a lupus cohort, who received at least one dose of a COVID-19 vaccine (inactivated virus, adenovirus-vectored, or mRNA vaccines) between March and October 2022 joined this study. The data regarding disease activity and flares after each dose were reviewed and compared. <b>Results:</b> Two hundred and one SLE patients (524 total doses) were included in this study, with 201, 199, and 124 of them receiving 1, 2, and 3 doses of a vaccine, respectively, which comprised 183, 128, and 213 doses of inactivated virus, adenovirus-vectored, and mRNA vaccines, respectively. Regardless of vaccine dose or type, there were no significant changes in SLE disease activity pre- or post-vaccination. Flares were significantly more common after the 2nd and 3rd doses than after the 1st one (20.10% and 17.74% vs. 8.96%, <i>p</i> = 0.001, and <i>p</i> = 0.010, respectively), and after inactivated virus, adenovirus-vectored and mRNA vaccinations in 11.48%, 14.84%, and 17.84% of the patients (<i>p</i> = ns), respectively. However, the incidence rate of flares/100 patient-months was not different. The majority of flares were severe, with renal flares being the most frequent. Renal and mucocutaneous involvement and high SLE disease activity prior to the 1st vaccine dose were independent factors that predicted flares. <b>Conclusions:</b> Flares after COVID-19 vaccination were not uncommon. Most of the flares were severe, mainly due to renal flares. SLE patients should have stable low disease activity prior to receiving COVID-19 vaccine in order to avoid flares.https://www.mdpi.com/2076-393X/12/12/1399systemic lupus erythematosusCOVID-19 vaccinedisease activityflares
spellingShingle Worawit Louthrenoo
Punsita Tangkum
Nuntana Kasitanon
Wanitcha Gumtorntip
Poramed Winichakoon
Supparat Konsamun
Antika Wongthanee
Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
Vaccines
systemic lupus erythematosus
COVID-19 vaccine
disease activity
flares
title Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
title_full Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
title_fullStr Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
title_full_unstemmed Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
title_short Flares and Predicting Factors of Flares in Patients with Systemic Lupus Erythematosus Associated with Different Doses and Types of COVID-19 Vaccines
title_sort flares and predicting factors of flares in patients with systemic lupus erythematosus associated with different doses and types of covid 19 vaccines
topic systemic lupus erythematosus
COVID-19 vaccine
disease activity
flares
url https://www.mdpi.com/2076-393X/12/12/1399
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