Improving Response to Influenza Vaccine in Patients with Rheumatoid Arthritis

Two-week interruption of methotrexate bolsters vaccine response but might raise risk for RA flares slightly.

Rheumatoid arthritis (RA) patients who are receiving immunosuppressive therapy with methotrexate (MTX) require regular vaccination against preventable diseases; however, such patients have attenuated responses to influenza and pneumococcal vaccines. Although suspending MTX improves vaccine immunogenicity, a study in South Korea showed that cessation of MTX for 4 weeks also was associated with slightly higher incidence of RA flares (Ann Rheum Dis 2017; 76:1559). Now, to determine if a 2-week interruption of MTX could improve vaccine immunogenicity without raising risk for RA flares, the same investigators randomized 320 RA patients on MTX therapy to influenza vaccination followed by MTX continuation versus cessation for 2 weeks.

Likelihood of…

Reviewing Author

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Improving Response to Influenza Vaccine in Patients with Rheumatoid Arthritis

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Reviewing Author