EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update

Robert B M Landewé^{1

2}, Féline P B Kroon^{3

4}, Alessia Alunno⁵, Aurélie Najm⁶, Johannes Wj Bijlsma⁷, Gerd-Rüdiger R Burmester⁸, Roberto Caporali⁹, Bernard Combe¹⁰, Richard Conway¹¹, Jeffrey R Curtis¹², Ori Elkayam¹³, Laure Gossec^{14

15}, Marloes W Heijstek¹⁶, Lukas Haupt¹⁷, Annamaria Iagnocco¹⁸, John D Isaacs¹⁹, István Ábel Juhász²⁰, Suzi Makri²¹, Xavier Mariette^{22

23}, Iain B McInnes^{24

25}, Puja Mehta^{26

27}, Ulf Mueller-Ladner²⁸, Hendrik Schulze-Koops²⁹, Josef S Smolen³⁰, Dieter Wiek³¹, Kevin L Winthrop³², Victoria Navarro-Compán³³, Pedro M Machado^{34

35

36}

Affiliations

¹ Clinical Immunology & Rheumatology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands landewe@rlandewe.nl.
² Department of Rheumatology and Clinical Immunology, Zuyderland Medical Center, Heerlen, The Netherlands.
³ Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands.
⁵ Life, Health and Environmental sciences, internal medicine and nephrology unit, University of l'Aquila, l'Aquila, Italy.
⁶ Institute of Infection Immunity and Inflammation, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK.
⁷ Rheumatology, University Medical Center Utrecht Department of Rheumatology and Clinical Immunology, Utrecht, The Netherlands.
⁸ Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany.
⁹ Department of Clinical Sciences and Community Health, ASS G. Pini, University of Milan, Milano, Lombardia, Italy.
¹⁰ Immunorhumatologie, CHU Lapeyronie, Montpellier, France.
¹¹ Rheumatology, Saint James's Hospital, Dublin, Ireland.
¹² University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, USA.
¹³ Rheumatology, Tel Aviv Medical Center, Tel Aviv, Israel.
¹⁴ INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France.
¹⁵ APHP, Rheumatology department, Hopital Universitaire Pitie Salpetriere, Paris, France.
¹⁶ Rheumatology &Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁷ 2nd Department of Medicine, Hietzing Hospital Vienna, Vienna, Austria.
¹⁸ Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy.
¹⁹ Institute of Translational and Clinical Research, Newcastle University and Musculoskeletal Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
²⁰ Centre of Rheumatology, Buda Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary.
²¹ Cyprus League for People with Rheumatism, Limassol, Cyprus.
²² Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux universitaires Paris-Sud - Hôpital Bicêtre, Le Kremlin Bicêtre, France.
²³ 3Université Paris-Sud, Center for Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Université Paris-Saclay, Le Kremlin Bicêtre, France.
²⁴ MVLS College Office, University of Glasgow, Glasgow, UK.
²⁵ Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
²⁶ Centre for Inflammation and Tissue Repair, UCL Respiratory Division of Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
²⁷ Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK.
²⁸ Rheumatology and Clinical Immunology, Giessen University, Bad Nauheim, Germany.
²⁹ Division of Rheumatology and Clinical Immunology, Internal Medicine IV, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany.
³⁰ Medicine 3, division of Rheumatology, Medical University of Vienna, Wien, Austria.
³¹ Deutsche Rheuma-Liga, Bonn, Germany.
³² Schools of Medicine and Public Health, division of Infectious Diseases, Oregon Health & Science University, Portland, Oregon, USA.
³³ Rheumatology, La Paz University Hospital, Madrid, Spain.
³⁴ Centre for Rheumatology and Department of Neuromuscular Diseases, University College London Hospitals (UCLH) NHS Foundation Trust, London, UK.
³⁵ Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
³⁶ Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.

PMID: 35197264
DOI: 10.1136/annrheumdis-2021-222006

Free article

EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update

Robert B M Landewé et al. Ann Rheum Dis. 2022 Dec.

Free article

. 2022 Dec;81(12):1628-1639.

doi: 10.1136/annrheumdis-2021-222006. Epub 2022 Feb 23.

Authors

Affiliations

¹ Clinical Immunology & Rheumatology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands landewe@rlandewe.nl.
² Department of Rheumatology and Clinical Immunology, Zuyderland Medical Center, Heerlen, The Netherlands.
³ Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands.
⁵ Life, Health and Environmental sciences, internal medicine and nephrology unit, University of l'Aquila, l'Aquila, Italy.
⁶ Institute of Infection Immunity and Inflammation, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK.
⁷ Rheumatology, University Medical Center Utrecht Department of Rheumatology and Clinical Immunology, Utrecht, The Netherlands.
⁸ Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany.
⁹ Department of Clinical Sciences and Community Health, ASS G. Pini, University of Milan, Milano, Lombardia, Italy.
¹⁰ Immunorhumatologie, CHU Lapeyronie, Montpellier, France.
¹¹ Rheumatology, Saint James's Hospital, Dublin, Ireland.
¹² University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, USA.
¹³ Rheumatology, Tel Aviv Medical Center, Tel Aviv, Israel.
¹⁴ INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France.
¹⁵ APHP, Rheumatology department, Hopital Universitaire Pitie Salpetriere, Paris, France.
¹⁶ Rheumatology &Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁷ 2nd Department of Medicine, Hietzing Hospital Vienna, Vienna, Austria.
¹⁸ Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy.
¹⁹ Institute of Translational and Clinical Research, Newcastle University and Musculoskeletal Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
²⁰ Centre of Rheumatology, Buda Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary.
²¹ Cyprus League for People with Rheumatism, Limassol, Cyprus.
²² Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux universitaires Paris-Sud - Hôpital Bicêtre, Le Kremlin Bicêtre, France.
²³ 3Université Paris-Sud, Center for Immunology of Viral Infections and Auto-immune Diseases (IMVA), Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Université Paris-Saclay, Le Kremlin Bicêtre, France.
²⁴ MVLS College Office, University of Glasgow, Glasgow, UK.
²⁵ Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
²⁶ Centre for Inflammation and Tissue Repair, UCL Respiratory Division of Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
²⁷ Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK.
²⁸ Rheumatology and Clinical Immunology, Giessen University, Bad Nauheim, Germany.
²⁹ Division of Rheumatology and Clinical Immunology, Internal Medicine IV, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany.
³⁰ Medicine 3, division of Rheumatology, Medical University of Vienna, Wien, Austria.
³¹ Deutsche Rheuma-Liga, Bonn, Germany.
³² Schools of Medicine and Public Health, division of Infectious Diseases, Oregon Health & Science University, Portland, Oregon, USA.
³³ Rheumatology, La Paz University Hospital, Madrid, Spain.
³⁴ Centre for Rheumatology and Department of Neuromuscular Diseases, University College London Hospitals (UCLH) NHS Foundation Trust, London, UK.
³⁵ Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
³⁶ Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.

PMID: 35197264
DOI: 10.1136/annrheumdis-2021-222006

Abstract

The first EULAR provisional recommendations on the management of rheumatic and musculoskeletal diseases (RMDs) in the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), largely based on expert opinion, were published in June 2020. Since then, an unprecedented number of clinical studies have accrued in the literature. Several SARS-CoV-2 vaccines have been approved for population-wide vaccination programmes in EULAR-affiliated countries. Studies regarding vaccination of patients with (inflammatory) RMDs have released their first results or are underway.EULAR found it opportune to carefully review to what extent the initially consensus expert recommendations stood the test of time, by challenging them with the recently accumulated body of scientific evidence, and by incorporating evidence-based advice on SARS-CoV-2 vaccination. EULAR started a formal (first) update in January 2021, performed a systematic literature review according to EULAR's standard operating procedures and completed a set of updated overarching principles and recommendations in July 2021. Two points to consider were added in November 2021, because of recent developments pertaining to additional vaccination doses.

Keywords: Covid-19; antirheumatic agents; vaccination.

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Conflict of interest statement

Competing interests: RBML received honoraria for lecturing and consultation from AbbVie, Amgen, BMS, Celgene, Galapagos, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB, is chair of EULAR’s committee for the quality of care and is owner and director of Rheumatology Consultancy BV. RBML is chair of EULAR’s committee of quality of care. AN received honoraria for lectures and consulting form BMS, UCB, Chigai and Roche. JWJB received honoraria for lectures and consulting from Fresnius, Galapagos, Syneos. GRB received honoraria for lectures and consulting from AbbVie, Amgen, BMS, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, Roche, UCB. RC received honoraria for lectures from AbbVie, Janssen, Roche, Sanofi. BC received honoraria for lecturing and consultation from AbbVie, BMS, Celltrion, Galapagos, Gilead, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Roche-Chugai. RC received honoraria for lectures and consulting or travel support from AbbVie, Janssen, Nordic Pharma, Roche and Sanofi. JRC received research grants and consulting from Amgen, AbbVie, BMS, GSK, Janssen, Lilly, Novartis, Pfizer, and chairs the ACR COVID Vaccine Guidance Task Force. OE received honoraria for lecturing and consultation from AbbVie, BMS, Celgene, Gilead, Janssen, Eli Lilly, Novartis, Pfizer and B.I. MWH Consultation and speaker’s fees from ALK and Roche. LH received a speaker’s fee from Grünenthal, honoraria for writing articles from MedMedia, and travel support from AbbVie, Biogen, BMS, MSD, Novartis and Roche. AI received consultancies, honoraria, speaker-fees from AbbVie, MSD, Alfasigma, Celltrion, BMS, Celgene, Eli Lilly, Sanofi, Genzyme, Pfizer, Galapagos, Gilead, Novartis, SOBI and research grants from MSD, Alfasigma, AbbVie. AI is acting president of EULAR. JDI received research grants from Pfizer, Janssen and GSK and honoraria for lectures, conference support from Eli Lilly and Gilead, and speaker/consulting fees from AbbVie, Gilead, Roche and UCB. XM received consulting fees from BMS, Gilead, Janssen, Pfizer, Samsung, UCB. BC received honoraria from AbbVie, BMS, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, Roche-Chugai, Sanofi and UCB; and research grants from Novartis, Pfizer, and Roche. IBM received research grants from Lilly, Pfizer, BMS, Celgene, Janssen; and consulting fees from AbbVie, BMS, Celgene, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis and UCB. IBM is past president of EULAR. HS-K received honoraria for lectures and consulting from AbbVie, Amgen, BMS, Gilead, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, Roche and UCB. JSS received grants to his institution from AbbVie, AstraZeneca, Janssen, Lilly, MSD, Pfizer and Roche and provided expert advice for, or had symposia speaking engagements with, AbbVie, Amgen, AstraZeneca, Astro, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Gilead, ILTOO Pharma, Janssen, Lilly, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi and UCB. JSS is editor of the Annals of Rheumatic Diseases. KW received honoraria and consultancy fees from AbbVie, Lilly, Roche, GSK, Novartis, BMS, Pfizer, UCB, Janssen, Regeneron and Sanofi. VN-C received research grants/honoraria from AbbVie, Janssen, Lilly, Novartis, Pfizer, and UCB. PMM received consulting/speaker’s fees from AbbVie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this manuscript.

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EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update

Affiliations

EULAR recommendations for the management and vaccination of people with rheumatic and musculoskeletal diseases in the context of SARS-CoV-2: the November 2021 update

Authors

Affiliations

Abstract

Conflict of interest statement

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Grants and funding

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