AB1305 RHEUMATOID ARTHRITIS FLARE FOLLOWING COVID-19 VACCINATION IN MALAYSIAN POPULATION AND ITS ASSOCIATED RISK FACTORS

Background Flare of Rheumatoid Arthritis (RA) following COVID-19 vaccination has been reported with a low occurrence observed in those patients disease remission. However, no local data is available our multi-ethnic Malaysian population. Objectives To evaluate the prevalence RA flare and its associated risk factors. Methods This was cross-sectional study assessing based on patient-reported through self-administered questionnaires physician-reported flare. Patient self-reported defined as ‘a sudden worsening rheumatology condition or arthritis within 1 month post-vaccination’ while ‘an increment activity score 28-joint documented 3 months post-vaccination‘ from either scheduled unscheduled clinic visit. A total 186 attended Hospital Putrajaya May to July 2022 who completed primary under National Vaccination Programme were recruited. Demographic data, parameters including serology for rheumatoid factor (RF) anti-citrullinated peptide antibodies (ACPA), cessation modifying anti-rheumatic drugs (DMARDs) around vaccination, type vaccines adverse events examined using descriptive univariate analyses. Results Majority (93%) enrolled female mean age 58 years old (standard deviation, SD 12.2) duration 12 (SD 7.7). More than half seropositive (66% RF, 63% ACPA) 47.4% had double seropositivity (RF ACPA positive). All received DMARDs majority (71%) methotrexate (MTX), 21.5% leflunomide, 17.7% other DMARDs, small proportion (14%) receiving prednisolone. Only 4.8% biologics targeted synthetic drugs. Half remission prior vaccination. 62% Pfizer-BioNTech vaccine vaccine, followed by Sinovac-CoronaVac (24.6%) Oxford-AstraZeneca (13.4%) vaccines. booster dose administered 80% patients, which 88.7% vaccine. MTX therapy discontinued 39.4% (n=52) post-vaccination week duration. The only 12.9% (n=24) 14 10 flares (4 severe flare, 6 mild-moderate flare). rates higher during first second 29.2% respectively, 12.5% after Common effects fever (16.8%), myalgia (8.6%) arthralgia (6.4%). There significant differences between age, gender, types usage prednisolone, discontinuation post-vaccination. Although did not exhibit statistically rate post sub-analysis revealed four times positivity compared seronegative (12% vs 4%). Conclusion Prevelance post-COVID-19 population low. No factors identified although appeared have number flares. References [1]Bixio, R., Bertelle, D., Masia, M., Pistillo, F., Carletto, A. Rossini, M. (2021), Incidence Disease After BNT162b2 Coronavirus 2019 Patients With Remission. ACR Open Rheumatology, 3: 832-833. [2]Li X, Tong Yeung WWY, Kuan P, Yum SHH, Chui CSL, Lai FTT, Wan EYF, Wong CKH, Chan EWY, Lau CS, ICK. Two-dose possible among Hong Kong. Ann Rheum Dis. Apr;81(4):564-568. Acknowledgements: NIL. Disclosure Interests None Declared.