Briefly Halting Methotrexate Improves Flu Vaccine Effectiveness
In patients with rheumatoid arthritis (RA), temporarily halting methotrexate (MTX) treatment for 2 weeks following seasonal influenza vaccination helps improve the immunogenicity of the vaccine without increasing RA disease activity, according to a new study.
During the study, patients with RA receiving a stable dose of MTX were randomly assigned to either continue treatment with MTX (n = 156) or cease MTX (n = 160) for 2 weeks following receipt of the 2016-2017 quadrivalent seasonal influenza vaccine.
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Ultimately, higher rates of satisfactory vaccine response (75.5% vs 54.5%) and seroprotection for all 4 influenza antigens were observed in participants who temporarily halted MTX compared with those who continued MTX.
For the H1N1, H2N2, B-Yamagata, and B-Victoria antigens, between-group differences in seroprotection rates were found to be 10.7%, 15.9%, 13.7%, and 14.7%, respectively
Participants who halted MTX also demonstrated a higher increase in antibody titers against all 4 antigens vs those who continued MTX.
Notably, there were no significant between-group differences in change in disease activity, indicating that “a temporary MTX discontinuation for 2 weeks after vaccination improves the immunogenicity of seasonal influenza vaccination in patients with RA without increasing RA disease activity,” the researchers wrote.
—Christina Vogt
Reference:
Park JK, Lee YJ, Shin K, et al. Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomized clinical trial [Published online March 23, 2018]. Ann Rheum Dis. 10.1136/annrheumdis-2018-213222
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