Temporary Methotrexate Cessation Ups Flu Vaccine Efficacy in RA Patients

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Methotrexate is a widely used immunesuppressive agent
Methotrexate is a widely used immunesuppressive agent
The following article features coverage from ACR 2017 in San Diego, California. Click here to read more of MPR's conference coverage.

HealthDay News — For patients with rheumatoid arthritis (RA), temporary discontinuation of methotrexate (MTX) for two weeks after influenza vaccination is associated with improved immunogenicity of vaccination, according to a study presented at the annual meeting of the American College of Rheumatology, being held Nov. 3 to 8 in San Diego.

Jin Kyun Park, MD, from Seoul National University Hospital in Korea, and colleagues conducted a trial in which RA patients taking a stable dose of MTX were randomized to continue MTX (MTX-continue group) or to suspend MTX for two weeks after vaccination (MTX-hold group). The modified intention-to-treat population was composed of 316 patients who were vaccinated with seasonal quadrivalent influenza vaccine. 

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The researchers found that the proportion of patients who achieved satisfactory vaccine response was higher in the MTX-hold versus the MTX-continue group (75.5 versus 54.5%). The rate of seroprotection was higher for all four antigens post-vaccination in the MTX-hold versus the MTX-continue group (H1N1: 86.3 versus 75.6%; H3N2: 78.1 versus 62.2%; B-Yamagata: 88.1 versus 74.4%; B-Victoria: 75.6 versus 60.9%). There was no difference between the groups in disease activity after vaccination.

"Further studies are needed to address as to whether the increased immunogenicity by holding methotrexate for two weeks can prevent flu infection," Park said in a statement.

Two authors disclosed financial ties to pharmaceutical companies.

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