Effect of Temporary Methotrexate Discontinuation on Vaccine Immunogenicity and Disease Flare in Rheumatoid Arthritis: A Systematic Review.
BACKGROUND Methotrexate (MTX) is a cornerstone disease-modifying antirheumatic drug for rheumatoid arthritis (RA); however, it may attenuate vaccine-induced immune responses. Temporary MTX interruption around vaccination has been proposed to improve immunogenicity, but concerns remain regarding disease flare and safety...