PT  - JOURNAL ARTICLE
AU  - Chio Yokose
AU  - Natalie McCormick
AU  - Clara Chen
AU  - Tuhina Neogi
AU  - Christine Chaisson
AU  - Robert Terkeltaub
AU  - David J Hunter
AU  - Yuqing Zhang
AU  - Hyon Choi
TI  - Risk of gout flares after vaccination: a prospective case cross-over study
AID  - 10.1136/annrheumdis-2019-215724
DP  - 2019 Nov 01
TA  - Annals of the Rheumatic Diseases
PG  - 1601--1604
VI  - 78
IP  - 11
4099  - http://ard.bmj.com/content/78/11/1601.short
4100  - http://ard.bmj.com/content/78/11/1601.full
SO  - Ann Rheum Dis2019 Nov 01; 78
AB  - 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.