ReviewAnnals of the rheumatic diseases2021
Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases.
Review in Annals of the rheumatic diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- The Asia Pacific League of Associations for Rheumatology (APLAR) Consensus Statements for the Management of Reproductive Issues in Autoimmune Rheumatic Diseases.International journal of rheumatic diseases · 2026Pooled it
- [Vaccination of immunocompromised individuals: Expert opinion - update 2026].Wiener klinische Wochenschrift · 2026Guideline
- Pooled it
- A Multicenter, Prospective, Randomized, Parallel-Group Trial on the Effects of Temporary Methotrexate Discontinuation for One Week Versus Two Weeks on Seasonal Influenza Vaccination in Patients With Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2023Trial
- Interaction of TNFi and conventional synthetic DMARD in SARS-CoV-2 vaccine response in axial spondyloarthritis and psoriatic arthritis.Joint bone spine · 2023Trial
- Anti-SARS-CoV-2 inactivated vaccine in patients with ANCA-associated vasculitis: Immunogenicity, safety, antibody decay and the booster dose.Clinics (Sao Paulo, Brazil) · 2023Trial
- Targeting Interleukin-6 for Treatment of CKD and Cardiovascular Disease.Kidney international reports · 2026Review
- Review
- Rapid on-off effects of methotrexate on lymphocytes may facilitate recovery of suppressed vaccine immunogenicity after its short-term methotrexate discontinuation in rheumatoid arthritis.Frontiers in immunology · 2026Article
- Effectiveness and Safety of Recombinant Zoster Vaccine in Rheumatic Diseases: Real-World Evidence from a Single-Centre Italian Cohort.Vaccines · 2025Article
- Preliminary Case-Control Study of Antibody Response to Vaccines in Children on bDMARDs.Children (Basel, Switzerland) · 2025Article
- Understanding dentists' antibiotic prescribing behaviour in Spain: a focus group study.JAC-antimicrobial resistance · 2025Article
- Comparison of T cell response to vaccination in rheumatic patients treated with Janus kinase inhibitors and TNF inhibitors.BMC rheumatology · 2025Article
- Article
- Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster.Arthritis research & therapy · 2025Observational
- Musculoskeletal diseases, infections and vaccines: state of the art, research perspectives and educational needs.Aging clinical and experimental research · 2025Review
- Risk of hospitalization with infection in adults with primary AIHA treated with rituximab: a French nationwide study.Blood advances · 2025Article
- Immunological memory to COVID-19 vaccines in immunocompromised and immunocompetent children.Frontiers in cellular and infection microbiology · 2025Article
- Article
- Humoral responses to multiple SARS-CoV-2 variants after two doses of vaccine in kidney transplant patients.Virulence · 2024Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
Patients with rheumatic diseases are at increased risk of infectious complications; vaccinations are a critical component of their care. Disease-modifying antirheumatic drugs may reduce the immunogenicity of common vaccines. We will review here available data regarding the effect of these medications on influenza, pneumococcal, herpes zoster, SARS-CoV-2, hepatitis B, human papilloma virus and yellow fever vaccines. Rituximab has the most substantial impact on vaccine immunogenicity, which is most profound when vaccinations are given at shorter intervals after rituximab dosing. Methotrexate has less substantial effect but appears to adversely impact most vaccine immunogenicity. Abatacept likely decrease vaccine immunogenicity, although these studies are limited by the lack of adequate control groups. Janus kinase and tumour necrosis factor inhibitors decrease absolute antibody titres for many vaccines, but do not seem to significantly impact the proportions of patients achieving seroprotection. Other biologics (interleukin-6R (IL-6R), IL-12/IL-23 and IL-17 inhibitors) have little observed impact on vaccine immunogenicity. Data regarding the effect of these medications on the SARS-CoV-2 vaccine immunogenicity are just now emerging, and early glimpses appear similar to our experience with other vaccines. In this review, we summarise the most recent data regarding vaccine response and efficacy in this setting, particularly in light of current vaccination recommendations for immunocompromised patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.