New Advise for Patients with Rheumatoid Arthritis Treated with Methotrexate

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.