Risk of incident gout following exposure to recombinant zoster vaccine in US adults aged ≥50 years

IF 4.6 2区 医学 Q1 RHEUMATOLOGY
Chengchen Zhang , Alejandro Amill-Rosario , Abree Johnson , Haeyoung Lee , O'Mareen Spence , Driss Oraichi , Harry Seifert , Valentine Franck , Susan Gamble , Huifeng Yun , Susan dosReis
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引用次数: 0

Abstract

Objective

Assess the risk of incident gout following exposure to recombinant zoster vaccine (RZV).

Methods

This case-only, self-controlled risk interval study included a cohort of US fee-for-service Medicare (Part A, B, and D) beneficiaries aged ≥65 years. The exposure was receipt of at least one dose of the two-dose RZV regimen in 2018 or 2019. The risk and control windows were days 1–30 and days 31–60, respectively, following vaccination. Incident gout was defined as the first episode of gout during the risk or control window, with no evidence of gout in the last 365 days. We estimated the relative risk (RR) and 95 % confidence interval (CI) of incident gout in the risk window relative to the control window, using conditional Poisson regression models. Sensitivity analyses included a dose-compliant subanalysis of individuals who received dose 2 60–183 days after dose 1; dose-specific analysis; seasonality adjustment; and COVID-19 adjustment for potential detection bias due to the pandemic.

Results

The 1290 RZV-exposed individuals with incident gout were primarily White (86.98 %), male (61.16 %), and aged 70–79 years (55.82 %). The RR of incident gout was 1.00 (95 % CI 0.90, 1.12). In the dose-compliant sensitivity analysis (n = 959 cases of incident gout), the RR of incident gout was 0.99 (95 % CI 0.87, 1.13). The findings were unchanged in the dose-specific, seasonality, and COVID-19 sensitivity analyses.

Conclusion

The findings suggest that RZV is not significantly associated with an increased risk of incident gout in the Medicare population aged ≥65 years.

美国≥65 岁成年人接种重组带状疱疹疫苗后发生痛风的风险
目标评估暴露于重组带状疱疹疫苗(RZV)后发生痛风的风险。方法这项仅针对病例的自控风险间隔研究纳入了年龄≥65岁的美国付费医疗保险(A、B和D部分)受益人队列。暴露是指在 2018 年或 2019 年接受至少一剂两剂 RZV 方案。风险窗口和对照窗口分别为接种疫苗后的第 1-30 天和第 31-60 天。痛风事件被定义为在风险或对照窗口期间首次发作痛风,且在过去 365 天内没有痛风的证据。我们使用条件泊松回归模型估算了风险窗口期与对照窗口期发生痛风的相对风险 (RR) 和 95% 置信区间 (CI)。敏感性分析包括对剂量 1 后 60-183 天接受剂量 2 的个体进行符合剂量要求的子分析;剂量特异性分析;季节性调整;以及 COVID-19 调整,以消除大流行导致的潜在检测偏差。结果1290 名暴露于 RZV 的痛风患者主要为白人(86.98%)、男性(61.16%)和 70-79 岁的老年人(55.82%)。痛风发生率为 1.00 (95 % CI 0.90, 1.12)。在剂量敏感性分析(n = 959 例痛风患者)中,痛风发病率为 0.99(95 % CI 0.87,1.13)。结论研究结果表明,在年龄≥65岁的医保人群中,RZV与痛风发病风险的增加并无明显关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.20
自引率
4.00%
发文量
176
审稿时长
46 days
期刊介绍: Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.
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