Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination

Ann Rheum Dis. 2022 Aug;81(8):1189-1193. doi: 10.1136/annrheumdis-2022-222199. Epub 2022 Mar 11.

Abstract

Objectives: COVID-19 vaccination often triggers a constellation of transitory inflammatory symptoms. Gout is associated with several comorbidities linked to poor outcomes in COVID-19, and gout flares can be triggered by some vaccinations. We analysed the risk of gout flares in the first 3 months after COVID-19 vaccination with inactivated virus, and whether colchicine can prevent gout flares following post-COVID-19 vaccination.

Methods: A clinical delivery population-based cross-sectional study was conducted in the Gout Clinic at the Affiliated Hospital of Qingdao University between February and October 2021. Study participants were selected using a systematic random sampling technique among follow-up patients with gout. We collected data, including vaccinations and potential risk factors, using a combination of interviews, health QR codes and medical records. Logistic regression was used to adjust for covariates.

Results: We enrolled 549 gout participants (median age 39 years, 84.2% vaccinated). For the 462 patients who received COVID-19 vaccine, 203 (43.9%) developed at least one gout flare in the 3 months after vaccination. Most of these flares were experienced within 1 month after the first (99/119 (83.2%)) or second (70/115 (60.9%)) dose of vaccine. Compared with unvaccinated participants, COVID-19 vaccination was associated with higher odds of gout flare within 3 months (adjusted OR 6.02; 95% CI 3.00 to 12.08). Colchicine use was associated with 47% less likelihood of postvaccine gout flare.

Conclusion: COVID-19 vaccination was associated with increased odds of gout flare, which developed mainly in month 1 after each vaccine dose, and was negatively associated with colchicine prophylaxis.

Keywords: COVID-19; gout; vaccination.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / prevention & control
  • Colchicine* / therapeutic use
  • Cross-Sectional Studies
  • Gout Suppressants* / therapeutic use
  • Gout* / drug therapy
  • Humans
  • Symptom Flare Up*
  • Vaccination
  • Vaccines / therapeutic use

Substances

  • COVID-19 Vaccines
  • Gout Suppressants
  • Vaccines
  • Colchicine