News in brief: PRS better than HLA-B27 testing for AS screening; Shingles in RA patients receiving COVID-19 vaccine; De-stressing patients with sclerodoma;

Thursday, 22 Apr 2021

PRS better than HLA-B27 testing for AS screening

Polygenic Risk Scores (PRSs) have greater ability than other diagnostic tests to differentiate cases of ankylosing spondylitis (AS) from other causes of chronic back pain, UK research suggests.

A study involving 15,585 AS cases and 20 ,452 controls found that the discriminatory capacity of PRSs for identifying AS was greater than that of HLA-B27 testing, MRI scanning or CRP testing, either alone or in combination.

The discriminatory performance of PRS was dependent on ethnicity and it would be possible to develop unique PRS screening tools for Europeans and Asians, said Professor Matthew Brown of the NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.

The findings are published in Annals of Rheumatic Diseases.

Zoster reactivation seen in rheumatology patients receiving COVID-19 vaccine

The possibility that COVID-19 vaccination may trigger herpes zoster reactivation in patients with autoimmune inflammatory rheumatic diseases (AIIRD) has been raised by rheumatologists in Israel.

Six cases of zoster reactivation have been reported in an observational study monitoring post-vaccination adverse effects in 491 patients with AIIRD who received the Pfizer (BNT162b2 mRNA) vaccine, according to Dr Victoria Furer and colleagues at the Tel Aviv Sourasky Medical Center and Tel Aviv University.

The cases occurred soon after vaccination in younger patients (mean age 49 years) with stable disease such as  rheumatoid arthritis (n=4), Sjogren’s syndrome (n=1), and undifferentiated connective disease (n=1).

“The presented cases raise awareness to a potential causal link between COVID-19 vaccination as a trigger of HZ reactivation in relatively young patients with stable AIIRD,” the authors said in Rheumatology.

“While the causality between both events cannot be proved based on a small number of cases, further vigilance and safety monitoring of COVID-19 vaccination side effects is warranted,” they concluded.

SPIN-CHAT may reduce stress in systemic sclerosis

A mental health coping and support intervention to help people with systemic sclerosis during the COVID-19 pandemic has produced mixed results in an international study.

The SPIN-CHAT trial – which included patients from Australia offered patients with conditions such as sclerodoma a 4-week videoconference-based group intervention that provided education and practice with mental health coping strategies, and provided social support to reduce isolation.

While there was no effect on mental health outcomes at the end of the  intervention, it did reduce anxiety and depression symptoms six weeks after the intervention.

“This pattern of results might reflect the time needed to make behavioural changes or the ongoing social support that participants continued to provide to each other post-intervention,” concluded investigators including Associate Professor Mandy Nikpour, a consultant rheumatologist at St Vincent’s Hospital Melbourne.

More details in Lancet Rheumatology.

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