Table.
Immunomodulatory and immunosuppressive medication modifications among 1852 rheumatology patients at each COVID-19 vaccination
|
First vaccine dose (N=1852) |
Second vaccine dose (N=1173) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Overall medication uses (N=1373) | Any medication modification before vaccine (N=215) | Medication taken early before vaccine (N=41) | Medication delayed or skipped before vaccine (N=174) | Overall medication uses (N=899) | Any medication modification before or after vaccine (N=251) | Medication delayed or skipped between first and second dose (N=105) | Medication taken early before vaccine (N=41) | Medication delayed or skipped after vaccine (N=105) | ||
| Any Immunomodulatory or immunosuppressive medication (excluding corticosteroids) | 1203 (87·6%) | 204 (94·9%) | 37 (90·2%) | 167 (96·0%) | 796 (88·5%) | 241 (96·0%) | 102 (97·1%) | 36 (87·8%) | 103 (98·1%) | |
| Hydroxychloroquine | 381 (27·7%) | 24 (11·2%) | 11 (26·8%) | 13 (7·5%) | 219 (24·4%) | 20 (8·0%) | 5 (4·8%) | 13 (31·7%) | 2 (1·9%) | |
| Biologics | 364 (26·5%) | 94 (43·7%) | 13 (31·7%) | 81 (46·6%) | 245 (27·3%) | 104 (41·4%) | 46 (43·8%) | 10 (24·4%) | 48 (45·7%) | |
| TNF inhibitors† | 205 (14·9%) | 49 (22·8%) | 7 (17·1%) | 42 (24·1%) | 125 (13·9%) | 41 (16·3%) | 19 (18·1%) | 5 (12·2%) | 17 (16·2%) | |
| IL-1 inhibitors† | 4 (0·3%) | 1 (0·5%) | 0 | 1 (0·6%) | 3 (0·3%) | 1 (0·4%) | 0 | 1 (2·4%) | 0 | |
| IL-6 inhibitors‡ | 33 (2·4%) | 6 (2·8%) | 1 (2·4%) | 5 (2·9%) | 27 (3·0%) | 11 (4·4%) | 5 (4·8%) | 1 (2·4%) | 5 (4·8%) | |
| IL-17 or IL-23 inhibitors§ | 51 (3·7%) | 8 (3·7%) | 0 | 8 (4·6%) | 40 (4·4%) | 19 (7·6%) | 8 (7·6%) | 1 (2·4%) | 10 (9·5%) | |
| Abatacept | 31 (2·3%) | 16 (7·4%) | 3 (7·3%) | 13 (7·5%) | 19 (2·1%) | 13 (5·2%) | 5 (4·8%) | 2 (4·9%) | 6 (5·7%) | |
| Rituximab | 21 (1·5%) | 8 (3·7%) | 1 (2·4%) | 7 (4·0%) | 17 (1·9%) | 9 (3·6%) | 4 (3·8%) | 0 | 5 (4·8%) | |
| Belimumab | 19 (1·4%) | 6 (2·8%) | 1 (2·4%) | 5 (2·9%) | 14 (1·6%) | 10 (4·0%) | 5 (4·8%) | 0 | 5 (4·8%) | |
| Conventional synthetic DMARDs | 381 (27·7%) | 76 (35·3%) | 12 (29·3%) | 64 (36·8%) | 275 (30·6%) | 106 (42·2%) | 48 (45·7%) | 11 (26·8%) | 47 (44·8%) | |
| Methotrexate | 234 (17·0%) | 57 (26·5%) | 5 (12·2%) | 52 (29·9%) | 180 (20·0%) | 84 (33·5%) | 38 (36·2%) | 7 (17·1%) | 39 (37·1%) | |
| Other conventional synthetic DMARDs¶ | 147 (10·7%) | 19 (8·8%) | 7 (17·1%) | 12 (6·9%) | 95 (10·6%) | 22 (8·8%) | 10 (9·5%) | 4 (9·8%) | 8 (7·6%) | |
| Other DMARDs | 13 (0·9%) | 0 | 0 | 0 | 8 (0·9%) | 0 | 0 | 0 | 0 | |
| Ciclosporin | 2 (0·1%) | 0 | 0 | 0 | 1 (0·1%) | 0 | 0 | 0 | 0 | |
| Tacrolimus | 11 (0·8%) | 0 | 0 | 0 | 7 (0·8%) | 0 | 0 | 0 | 0 | |
| Small molecules | 64 (4·7%) | 10 (4·7%) | 1 (2·4%) | 9 (5·2%) | 49 (5·5%) | 11 (4·4%) | 3 (2·9%) | 2 (4·9%) | 6 (5·7%) | |
| Apremilast | 16 (1·2%) | 2 (0·9%) | 1 (2·4%) | 1 (0·6%) | 14 (1·6%) | 2 (0·8%) | 0 | 2 (4·9%) | 0 | |
| JAK inhibitors|| | 48 (3·5%) | 8 (3·7%) | 0 | 8 (4·6%) | 35 (3·9%) | 9 (3·6%) | 3 (2·9%) | 0 | 6 (5·7%) | |
| Corticosteroids | 170 (12·4%) | 11 (5·1%) | 4 (9·8%) | 7 (4·0%) | 103 (11·5%) | 10 (4·0%) | 3 (2·9%) | 5 (12·2%) | 2 (1·9%) | |
| Prednisone | 128 (9·3%) | 8 (3·7%) | 2 (4·9%) | 6 (3·4%) | 80 (8·9%) | 7 (2·8%) | 2 (1·9%) | 4 (9·8%) | 1 (1·0%) | |
| Methylprednisolone | 34 (2·5%) | 3 (1·4%) | 2 (4·9%) | 1 (0·6%) | 21 (2·3%) | 3 (1·2%) | 1 (1·0%) | 1 (2·4%) | 1 (1·0%) | |
| Steroid injection | 8 (0·6%) | 0 | 0 | 0 | 2 (0·2%) | 0 | 0 | 0 | 0 | |
Data are n (%). Rows not mutually exclusive (ie, patients were able to select ≥1 option). DMARDs=disease-modifying antirheumatic drugs. IL=interleukin. JAK=Janus kinase. TNF=tumour necrosis factor.
†
Infliximab, etanercept, adalimumab, golimumab, certolizumab pego.
†
Anakinra, canakinumab, rilonacept.
‡
Tocilizumab, sarilumab.
§
Secukinumab, ixekizumab, ustekinumab, guselkumab.
¶
Azathioprine or mercaptopurine, leflunomide, mycophenolate mofetil or mycophenolic acid, sulfasalazine.
||
Baricitinib, tofacitinib, upadacitinib.