Patients with rheumatoid arthritis treated with methotrexate mount a better immunological response to the flu vaccine if the next two doses of methotrexate are withheld.
Background to the Recommendation
The NNUH Rheumatology Department, supported by the Norfolk & Waveney Therapeutics Advisory Group (TAG), is therefore recommending the following:
Stable patients, defined as those who have not required an increase in methotrexate dose or rescue steroids in the last 8 weeks, should miss the next two doses of methotrexate following flu vaccination, as the risk of a rheumatoid flare is low, but there may be additional protection against flu.
This only applies to patients with rheumatoid arthritis.