The effect of tofacitinib on pneumococcal and influenza vaccine responses in rheumatoid arthritis

Ann Rheum Dis. 2015 Mar 20. pii: annrheumdis-2014-207191. doi: 10.1136/annrheumdis-2014-207191. [Epub ahead of print]

The increased risk of serious infection among RA patients means vaccinations against pneumococcus and influenza are recommended in this group of patients. Studies evaluating immune response to these vaccines in conjunction with DMARD therapy can provide clinicians with important information relating to things such as timing of vaccination.

This study aimed to assess the effect of tofacitinib on vaccine responses to PPSV-23 and the trivalent seasonal influenza vaccine in those whom tofacitinib treatment is being considered and those currently receiving tofacitinib.

The data shows that methotrexate and tofacitinib monotherapy result in similar reductions in responsiveness to the PPSV-23 vaccine, and this response is reduced further with concomitant therapy. Temporary tofacitinib discontinuation had limited effect upon influenza or PPSV-23 vaccine responses.

The authors conclude, that if possible, it is optimal to vaccinate patients with PPSV-23 prior to tofacitinib therapy start, and for those already on therapy, temporary stoppage of therapy will benefit these vaccine responses little, such that temporary discontinuation is not necessary