Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review

<h3>Background</h3><p dir="ltr">Patients with autoimmune rheumatic diseases (ARD) are at a potentially higher risk for COVID-19 infection complications. Given their inherent altered immune system and the use of immunomodulatory medications, vaccine immunogenicity could be...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Anwar I. Joudeh (16003142) (author)
مؤلفون آخرون: Abdu Qaid Lutf (16003145) (author), Salah Mahdi (14779066) (author), Gui Tran (3739468) (author)
منشور في: 2023
الموضوعات:
الوسوم: إضافة وسم
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author Anwar I. Joudeh (16003142)
author2 Abdu Qaid Lutf (16003145)
Salah Mahdi (14779066)
Gui Tran (3739468)
author2_role author
author
author
author_facet Anwar I. Joudeh (16003142)
Abdu Qaid Lutf (16003145)
Salah Mahdi (14779066)
Gui Tran (3739468)
author_role author
dc.creator.none.fl_str_mv Anwar I. Joudeh (16003142)
Abdu Qaid Lutf (16003145)
Salah Mahdi (14779066)
Gui Tran (3739468)
dc.date.none.fl_str_mv 2023-06-13T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.vaccine.2023.05.048
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_mRNA_and_AstraZeneca_COVID-19_vaccines_in_patients_with_autoimmune_rheumatic_diseases_A_systematic_review/23274386
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Chemical sciences
Medicinal and biomolecular chemistry
Adverse events
Autoimmune Rheumatic Disease
COVID-19 vaccine
Disease flare
Immunogenicity
Safety
dc.title.none.fl_str_mv Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Patients with autoimmune rheumatic diseases (ARD) are at a potentially higher risk for COVID-19 infection complications. Given their inherent altered immune system and the use of immunomodulatory medications, vaccine immunogenicity could be unpredictable with a suboptimal or even an exaggerated immunological response. The aim of this study is to provide real-time data on the emerging evidence of COVID-19 vaccines' efficacy and safety in patients with ARDs.</p><h3>Methods</h3><p dir="ltr">We performed a literature search of the PubMed, EMBASE, and OVID databases up to 11–13 April 2022 on the efficacy and safety of both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines in patients with ARD. The risk of bias in the retrieved studies was evaluated using the Quality in Prognostic Studies tool. Also, current clinical practice guidelines from multiple international professional societies were reviewed.</p><h3>Results</h3><p dir="ltr">We identified 60 prognostic studies, 69 case reports and case series, and eight international clinical practice guidelines. Our results demonstrated that most patients with ARDs were able to mount humoral and/or cellular responses after two doses of COVID-19 vaccine although this response was suboptimal in patients receiving certain disease-modifying medications including rituximab, methotrexate, mycophenolate mofetil, daily glucocorticoids >10 mg, abatacept, as well as in older individuals, and those with comorbid interstitial lung diseases. Safety reports on COVID-19 vaccines in patients with ARDs were largely reassuring with mostly self-limiting adverse events and very minimal post-vaccination disease flares.</p><h3>Conclusion</h3><p dir="ltr">Both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines are highly effective and safe in patients with ARD. However, due to their suboptimal response in some patients, alternative mitigation strategies such as booster vaccines and shielding practices should also be followed. Management of immunomodulatory treatment regimens during the peri vaccination period should be individualized through shared decision making with patients and their attending rheumatologists.</p><h2>Other Information</h2><p dir="ltr">Published in: Vaccine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1016/j.vaccine.2023.05.048" target="_blank">http://dx.doi.org/10.1016/j.vaccine.2023.05.048</a></p>
eu_rights_str_mv openAccess
id Manara2_949213a485da6cd59d7c770c48cfe844
identifier_str_mv 10.1016/j.vaccine.2023.05.048
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/23274386
publishDate 2023
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spelling Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic reviewAnwar I. Joudeh (16003142)Abdu Qaid Lutf (16003145)Salah Mahdi (14779066)Gui Tran (3739468)Biomedical and clinical sciencesClinical sciencesPharmacology and pharmaceutical sciencesChemical sciencesMedicinal and biomolecular chemistryAdverse eventsAutoimmune Rheumatic DiseaseCOVID-19 vaccineDisease flareImmunogenicitySafety<h3>Background</h3><p dir="ltr">Patients with autoimmune rheumatic diseases (ARD) are at a potentially higher risk for COVID-19 infection complications. Given their inherent altered immune system and the use of immunomodulatory medications, vaccine immunogenicity could be unpredictable with a suboptimal or even an exaggerated immunological response. The aim of this study is to provide real-time data on the emerging evidence of COVID-19 vaccines' efficacy and safety in patients with ARDs.</p><h3>Methods</h3><p dir="ltr">We performed a literature search of the PubMed, EMBASE, and OVID databases up to 11–13 April 2022 on the efficacy and safety of both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines in patients with ARD. The risk of bias in the retrieved studies was evaluated using the Quality in Prognostic Studies tool. Also, current clinical practice guidelines from multiple international professional societies were reviewed.</p><h3>Results</h3><p dir="ltr">We identified 60 prognostic studies, 69 case reports and case series, and eight international clinical practice guidelines. Our results demonstrated that most patients with ARDs were able to mount humoral and/or cellular responses after two doses of COVID-19 vaccine although this response was suboptimal in patients receiving certain disease-modifying medications including rituximab, methotrexate, mycophenolate mofetil, daily glucocorticoids >10 mg, abatacept, as well as in older individuals, and those with comorbid interstitial lung diseases. Safety reports on COVID-19 vaccines in patients with ARDs were largely reassuring with mostly self-limiting adverse events and very minimal post-vaccination disease flares.</p><h3>Conclusion</h3><p dir="ltr">Both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines are highly effective and safe in patients with ARD. However, due to their suboptimal response in some patients, alternative mitigation strategies such as booster vaccines and shielding practices should also be followed. Management of immunomodulatory treatment regimens during the peri vaccination period should be individualized through shared decision making with patients and their attending rheumatologists.</p><h2>Other Information</h2><p dir="ltr">Published in: Vaccine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1016/j.vaccine.2023.05.048" target="_blank">http://dx.doi.org/10.1016/j.vaccine.2023.05.048</a></p>2023-06-13T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.vaccine.2023.05.048https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_mRNA_and_AstraZeneca_COVID-19_vaccines_in_patients_with_autoimmune_rheumatic_diseases_A_systematic_review/23274386CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/232743862023-06-13T00:00:00Z
spellingShingle Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
Anwar I. Joudeh (16003142)
Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Chemical sciences
Medicinal and biomolecular chemistry
Adverse events
Autoimmune Rheumatic Disease
COVID-19 vaccine
Disease flare
Immunogenicity
Safety
status_str publishedVersion
title Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
title_full Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
title_fullStr Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
title_full_unstemmed Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
title_short Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
title_sort Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review
topic Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
Chemical sciences
Medicinal and biomolecular chemistry
Adverse events
Autoimmune Rheumatic Disease
COVID-19 vaccine
Disease flare
Immunogenicity
Safety