Safety of COVID-19 Vaccine in Patients with Rheumatic and Musculoskeletal Diseases.

Objectives: The main purpose of this study was to determine the frequency of COVID-19 vaccine side effects in patients with rheumatic diseases and to examine any potential associations with medications, disease type, or comorbidities. Methods: A multicentre cross-sectional study from rheumatology units in different hospitals in Iraq was carried out between 8th of August 2021 and 4th of August 2022. Patients were eligible for inclusion if they have a rheumatic disease and have taken one or more doses of any COVID-19 vaccine. Results: A total of 661 (57.8% female, mean age 46.51± 12.97 years) patients with rheumatic illnesses who received the "COVID-19" vaccination were included in this study. Rheumatoid arthritis was the most frequent diagnostic group. The Pfizer vaccine was given to the majority of patients (74.6%), followed by Sinopharm (16.2%), and AstraZeneca (9.2%). Side effects were detected in 661(100%) and 528 (100%) patients following the first and second vaccination doses, respectively; among which the most frequent were injection site pain in 57.8% following the first dose and 47.6% after the second dose, followed by fatigue and fever. According to multivariate logistic regression models, age (B=-0.204, p = 0.000), had a significantly inverse correlation coefficient with the experience of greater side effects. Rheumatic disease flares reported in 9.9%, 10.3%, and 8.2% of patients who received the Pfizer, Sinopharm, and AstraZeneca vaccines, respectively. Conclusion: The "COVID-19" vaccination has a reassuring safety profile with no greater risk of adverse events in any specific illness or pharmacological therapy.

A 5 item version of the Workplace Activity Limitation Scale successfully identifies impaired work productivity in rheumatoid arthritis patients: A split-sample factor analysis approach.

BACKGROUND: There is a growing interest in studying the effects of arthritis on a person's work productivity using a growing variety of outcome indicators. OBJECTIVES: To develop a valid and reliable shortened version of the Workplace Activity Limitation Scale 12 (WALS-12) for assessing work productivity limitations in rheumatoid arthritis (RA) patients. METHODS: A cross-sectional study involving 277 RA patients was conducted. An exploratory factor analysis on WALS-12 was used for item reduction on the first sample. Then confirmatory factor analysis (CFA) was run to establish the best fit indices of the reduced version. On the second sample, CFA and linear discriminant analysis were performed to assess the diagnostic performance and discriminant ability of the reduced form. A Bland-Altman method was used to find the agreement between the WALS-12 and the reduced one. RESULTS: The WALS-12 was reduced to 5 items. The Cronbach α was 0.817, with a composite reliability of 0.715. The Spearman rho correlation coefficient ranged between 0.675 and 0.795 for WALS-5, which was higher for the scale items with their domains than the correlation of WALS-5 with the domains of Work Limitations Questionnaire-25. Also, the root square of the average variant extracted from WALS-5 was 0.802. WALS-5 showed excellent discriminant ability with an area under the curve of 0.98 (P < .001), sensitivity of 97%, specificity of 82%, and accuracy of 94%. The reduced version WALS-5 was in agreement with the original version WALS-12. CONCLUSIONS: WALS-5 is a valid and reliable tool to assess the work productivity limitations in RA patients.

The Use of Biosimilars in the Middle East: Review Article.

PURPOSE OF REVIEW: Biosimilars are of growing importance worldwide, and many leading countries are introducing them in their health care systems and are using them in many fields of medicine owing to their low price tags in comparison with the brands and to their similarities in terms of function and side effects. So we cannot look past them and continue to rely on the innovator drugs since many had proven their efficacies in number of researches and Trials, not to mention the burden that many diseases pose on the budgets of the third world countries making using a lower priced alternatives a much appealing choice for the decision makers. Many fields of medicine in Iraq have experiences with the use of these agents over the past few years like the use of vaccines, insulin, and Growth factors, but their use in rheumatic disorders is still unfamiliar in our country. Our main aim doing this Review was to go through the written data on use of biosimilars in nearby countries and regions and draw some information regarding Types used, Terms of use and market release, different related legislations- if any-, patient's selection criteria for their use in case of the presence of Brands, and examine the systems of successful pharmacovigilance, to guide us in producing our own guidance for perfect utilization of the newly arriving drugs. RESULTS: Overall, there were 21 separate articles in which the biosimilars were mentioned as integral parts of the reviews and main body of subject. Even these reports have deficiencies in descriptions of types of drugs, Prices, Patient selection strategies and Efficacy studies. CONCLUSIONS: The biosimilar use is still considered a new encounter in the Middle Eastern areas, many countries have never had any experience with their use, With Very little published data in this regard. RECOMMENDATION: We advise the researchers and workers in this Region to pay more attention to documentation and publication of their works and experiences.