Temporary MTX Discontinuation Improves Flu Vaccine Immunogenicity in RA

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The rate of seroprotection was higher for all 4 antigens post-vaccination in the MTX-hold.
The rate of seroprotection was higher for all 4 antigens post-vaccination in the MTX-hold.

HealthDay News — For patients with rheumatoid arthritis (RA), temporary discontinuation of methotrexate (MTX) for 2 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 held from 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 2 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.

The researchers found that the proportion of patients who achieved satisfactory vaccine response was higher in the MTX-hold vs the MTX-continue group (75.5% vs 54.5%). The rate of seroprotection was higher for all 4 antigens post-vaccination in the MTX-hold vs the MTX-continue group (H1N1: 86.3% vs 75.6%; H3N2: 78.1% vs 62.2%; B-Yamagata: 88.1% vs 74.4%; B-Victoria: 75.6% vs 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 2 weeks can prevent flu infection," Park said in a statement.

Two authors disclosed financial ties to pharmaceutical companies.

Reference

Park JK, Shin K, Ha YJ, et al. Temporary methotrexate discontinuation for 2 weeks improves immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomized clinical trial. Presented at: 2017 American College of Rheumatology 2017 Annual Meeting; November 3-8, 2017; San Diego, CA. Abstract 827.

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