EVALUATION OF RESPONSE TO ADJUVANTED RECOMBINANT ZOSTER VACCINATION IN PATIENTS WITH RHEUMATOID ARTHRITIS RECEIVING UPADACITINIB: RESULTS FROM A RANDOMIZED TRIAL SUB-STUDY
Authors: K. Winthrop et al.
This study explored whether or not it is efficacious to vaccinate RA patients on both methotrexate and on a JAK-inhibitor (upadacitinib) against Herpes Zoster Virus (HZV) with an adjuvanted recombinant zoster vaccine (Shingrix®). The outcome of interest was a strong humoral response (≥ 4-fold increase in titers) against HZV. A good humoral response to RZV occurred in 64% (CI: 55–74) of patients after the first vaccination and in 88% (CI: 81–95) after the second vaccination. Within 30 days post-vaccination of either RZV dose, no serious adverse events (AEs) were reported.
As we know from the recent experience with the COVID-19 vaccine, some of our antirheumatic therapies decrease the response to vaccinations. In several studies both methotrexate and JAK-inhibitors have been associated with a decreased response to the COVID-19 and the influenza vaccination. The results of this study suggest that while the response rates may be slightly decreased compared to a healthy population, 9 out of 10 patients are able to mount a satisfactory response to HZV with this vaccine while continuing their therapy.
It would have been of interest to study whether a short 1 or two week pause with these therapies would have increased the response to the HZV vaccination.