ACR: Holding Methotrexate for Just a Week After Flu Vaccine Works for RA Patients

FRIDAY, Nov. 18, 2022 (HealthDay News) — For patients with rheumatoid arthritis (RA), temporarily discontinuing methotrexate for one week is noninferior to discontinuation for two weeks after seasonal flu vaccination to induce an immediate and long-term satisfactory vaccine response, according to a study presented at the annual meeting of the American College of Rheumatology, held from Nov. 10 to 14 in Philadelphia.

Jin Kyun Park, M.D., from the Seoul National University College of Medicine in South Korea, and colleagues assessed whether discontinuing methotrexate for one week after seasonal influenza vaccination is noninferior to discontinuing for two weeks among RA patients with regards to immediate and long-term vaccine response. The analysis included patients randomly assigned to a one-week (90 patients) or two-week hold (88 patients) of methotrexate following the quadrivalent 2021-2022 seasonal influenza vaccine.

The researchers found that the proportion of satisfactory vaccine responses did not differ between the groups at four weeks (68.9 versus 75.0 percent) and at 16 weeks (69.6 versus 70.3 percent). Additionally, at four and 16 weeks, the proportion of patients reaching seroprotection and the rise in antibody titer were similar between the groups. Similar vaccine responses were seen among RA patients and controls.

“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,” Park said in a statement. “But it is not clear yet whether skipping methotrexate for one week improves response to other vaccines.”

One author disclosed financial ties to the pharmaceutical industry.

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