Holding methotrexate for one week after flu vaccine as effective as two-week hold among RA patients

The primary outcome was a positive response at four weeks post vaccination, defined as a four-fold or greater increase in antibody titers against at least two of the vaccine strains. Secondary outcomes were positive response and antibody titers at four- and 16-weeks post vaccination.

The proportion of patients achieving satisfactory vaccine responses were similar in the one- and two-week groups at four weeks and 16 weeks (69% versus 75% and 69.6% versus 70.3%, respectively). The vaccine responses in the RA patients and controls were also similar.

"Patients and physicians alike do not often know what to do with methotrexate when a vaccination, including the annual flu vaccine or novel COVID-19 vaccines, is required. It was relieving to find out that skipping methotrexate for one week is as effective as skipping it for two weeks to improve vaccine response with no increase in disease flare risk," Dr. Park says. "But it is not clear yet whether skipping methotrexate for one week improves response to other vaccines."

The next step, Dr. Park says, is to see if this approach can be applied to other DMARDs and vaccines.

Reference:

 Yun Jong Lee, Kichul Shin, Eun Ha Kang, You-Jung Ha, Min Jung Kim, Jun Won Park, SE RIM CHOI, Mi Hyeon Kim, Ji In Jung, Ju Yeon Kim, Kevin Winthrop and Eun Bong Lee,Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea, Seoul National University Bundang Hospital, Seongnam, Republic of Korea, Seoul Metropolitan Government- Seoul National University Boramae Medical Center, Seoul, Republic of Korea,Seoul Metropolitan Government Boramae Medical center, Dongjak-gu, Seoul, Republic of Korea,Seoul National University Hospital, Seoul, Republic of Korea, Oregon Health & Science University, Portland, OR