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Medicine Matters rheumatology

So the safety profile of COVID-19 vaccines in patients with rheumatic diseases was very reassuring. Disease flares were reported by 5% of patients with inflammatory rheumatic diseases, with only 1% being classified as severe flares. The potential vaccine side effects were reported by 31% of the patients.


The majority of the side effects were typical, early adverse events occurring one week after vaccination, namely, pain at the site of injection or fatigue or headaches. Now, these are all very common adverse events, similar to what has been reported in the general population and similar to what has been seen in many other vaccines.



There were only two cases of severe adverse events, one in a patient with an overlap syndrome-- an overlap between lupus and systemic sclerosis-- and one case in a patient with osteoarthritis. So in summary, the data suggests that the protection offered by the vaccine clearly outweighs any risk of flair or adverse event in our patients.



So the EULAR COVID-19 vaccination registry-- or COVAX registry-- is an observational registry. We launched the registry on the 5th of February 2021. And the data is entered voluntarily by clinicians or associated health care professionals. And the patients are eligible for inclusion in the registry if they have a rheumatic disease and have been vaccinated against SARS-COV-2 with any type of vaccine.



Now, as of the 27th of April, 2021, 1,519 patients were reported to the registry. And this is the data being reported at the EULAR meeting. We now have close to 3,000 patients reported to the registry. The majority of patients were female-- 68%-- and above the age of 60-- 57%. A total of 28 countries contributed to the registry, with France and Italy being the highest contributors.



More than 90% of the patients reported to the registry had an inflammatory rheumatic disease. So conditions like rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus, or vasculitis. Now, at the time of vaccination, 45% of the patients were taking some type of conventional disease-modifying anti-rheumatic drug, or DMARD. 36% of them were taking biological DMARDs.



31% were taking glucocorticoids, 6% any other type of immunosuppressive drug, and 3% were taking a targeted synthetic DMARD. Now finally, the majority of the patients had been vaccinated with the Pfizer vaccine-- 78% to be exact-- with the remaining subjects having been vaccinated with one of the other vaccines, namely the Moderna or the Oxford AstraZeneca vaccine.



In summary, I think the population is highly representative of the subjects in our rheumatology clinics. I think these initial findings should provide the reassurance that we needed-- the reassurance to rheumatologists and to vaccine recipients. And they should promote confidence in COVID-19 vaccination in patients with rheumatic diseases. Vaccines are one of the greatest medical events of modern times. They prevent millions and millions of deaths yearly, and many more million deaths will be prevented with COVID-19 vaccines.