Risk of gout flares after vaccination: a prospective case cross-over study.

Abstract:

OBJECTIVES:The recombinant zoster vaccine (RZV) containing a strong non-aluminium adjuvant is associated with increased risk of gout flares, presumably via NLRP3 inflammasome activation. We tested the possibility that other vaccines may also be associated with gout flares. METHODS:We conducted an online case-crossover study of patients with gout to examine the association between vaccination and gout flares. We collected information through the Internet on exposures to potential risk factors, including vaccinations, during 2-day hazard periods prior to gout flare and 2-day control periods without a flare. Conditional logistic regression was used to adjust for covariates. RESULTS:There were 517 participants with gout (mean age 55 years, 79% male) who experienced gout flares during follow-up. There were 28 vaccinations during 990 hazard periods and 21 vaccinations during 1407 control periods. Vaccination was associated with twofold higher odds of gout flare (adjusted OR 1.99; 95% CI 1.01 to 3.89). CONCLUSION:Our findings suggest vaccines other than RZV are associated with increased odds of gout flares, potentially through a shared pathogenetic mechanism like NLRP3 inflammasome. However, the absolute magnitude of increased odds of gout flares with vaccinations remains small and must be interpreted within the context of the overwhelming benefits of vaccinations.

journal_name

Ann Rheum Dis

authors

Yokose C,McCormick N,Chen C,Neogi T,Chaisson C,Terkeltaub R,Hunter DJ,Zhang Y,Choi H

doi

10.1136/annrheumdis-2019-215724

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

1601-1604

issue

11

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2019-215724

journal_volume

78

pub_type

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