COVID-19 Vaccination Safe, Effective for Patients With SpA

Patients with spondyloarthritis (SpA) are not at higher risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, severe illness, or death compared with the general population, and vaccination against COVID-19 appears safe and effective with most disease-modifying antirheumatic drugs (DMARDs). The findings, which stemmed from a narrative review, were published in Rheumatology and Therapy.

“The European Alliance of Associations for Rheumatology and the American College of Rheumatology (ACR) acknowledge the limited data on safety and efficacy of the COVID-19 vaccines in this patient population; however, both recommend that all patients with rheumatic diseases, including SpA, receive any available COVID-19 vaccine as soon as possible since the potential benefit outweighs the low likelihood of potential harm,” wrote lead and corresponding author Atul Deodhar, MD, of Oregon Health and Science University, and coauthors.

The review assessed available evidence on COVID-19 illness and vaccination in patients with SpA who receive DMARDs, a population vulnerable to infections and with a seemingly high prevalence of risk factors associated with severe COVID-19.

According to the review, patients with SpA treated with DMARDs have SARS-CoV-2 infection rates comparable with those in the general population. Older age and comorbidities in patients are associated with increased risk, similar to the general population.

Although available evidence has shown COVID-19 vaccination in patients with SpA to be safe and effective with most DMARDs, limited evidence suggests certain therapies, such as methotrexate and Janus kinase (JAK) inhibitors, may interfere with vaccine response. ACR provides specific recommendations concerning short-term cessation of methotrexate, JAK inhibitors, and other treatments in its COVID-19 vaccine guidance, according to the review.

No evidence indicates an increased risk of adverse events with COVID-19 vaccination in patients with SpA treated with DMARDs.

“Providers should counsel and educate patients on the available data, benefits of vaccination, and expert recommendations regarding COVID-19 vaccination to dispel misinformation and prevent vaccine hesitancy,” the authors advised.

—Jolynn Tumolo

Reference
Deodhar A, Bhana S, Winthrop K, Gensler LS. COVID-19 outcomes and vaccination in patients with spondyloarthritis. Rheumatol Ther. 2022;9(4):993-1016.