Methotrexate and flu jab research

[Bookworm55]

This is quite interesting.

Methotrexate drug holiday improves flu vaccine efficacy in rheumatoid arthritis patients - Science Magazine

apple.news/ATdRU6MXBQ7SDxwB...

[Simba1992]

Interesting. Something valuable to know for those who take the flu shot👍🏻and on mtx.

[nomoreheels]

Makes you wonder why it's not filtered through to NICE & related guidelines, unless the one trial isn't considered proof enough?

[ITYFIALMCTT]

It's a poster/abstract at a professional meeting in the US of a multi-centre trial that seems to have been lead out of Seoul so there's little known, as yet, about the demographics of the participants in the trial - and whether this finding would be replicated:

i) in other demographics of people with RA;

ii) for vaccines of a different make-up.

It is interesting. I could bear knowing whether it is oral MTX or injectable and the 'average' dose, whether there were additional drugs in the mix etc. but it would need publication in a journal (and in greater detail).

[nomoreheels]

I checked other publications before replying & as far back as May 2017 it was reported the-rheumatologist.org/arti... so with that & the trial ending back in January prompted my question really.

[ITYFIALMCTT in reply to nomoreheels]

They're both nicely elegant trials across different years of flu seasons.

It will be good to see the detail of both trials and if it encourages a replication in other countries and more widely with other vaccines.

[Bookworm55 in reply to nomoreheels]

As you say then- wonder why it hasn’t filtered through to NICE etc.

[helixhelix]

Interesting, but I longer get excited by a single trial of such a small number of people especially there isn't a direct correlation between antibody production and immune protection - which it says in the paper too. One for the future perhaps....

[Simba1992]

New research on flu shots. Makes you really wonder...😳

ewao.com/2017/08/16/johns-h...

[Bookworm55 in reply to Simba1992]

It certainly does! There are so many conflicting studies it's difficult to know what to think or do. I had my first ever flu jab in 2015 and 6 weeks later RA hit me completely out of the blue. I try really hard not to connect the two........

[Simba1992 in reply to Bookworm55]

The research actually supports the mtx stopping study. If the flu shot infact depresses the immune system for five weeks, it is only logical that adding the mtx to the immunosuppression would in fact leave the patient very vulnerable to, in fact catching the flu!

[Bookworm55 in reply to Simba1992]

I agree. What to do though? More research needed.

[Simba1992 in reply to Bookworm55]

Well it depends. It is obious that there is really no research that supports taking flu shots if you are a senior or chronicly ill! So why in the world if we belong to these groups do we take the flu shot?! if there is no evidence or research on benefits, only risk taking!

[Bookworm55 in reply to Simba1992]

There were reports in the papers the other week saying that a couple of years ago the incidence of flu among those who’d had the jab that winter was the same as those who hadn’t! Think that might have referred specifically to over 65s but still.........

[Simba1992 in reply to Bookworm55]

I would really like to see research that clearly shows that there is a benefit of flu vaccine for those over 65 and those who are chronicly ill. At least what the above research states that these studies do not exist. So why are all these believers in meds and pharma following something that there is no medical evidence for?

[ITYFIALMCTT]

Just as a general comment, the ethnic make-up of the study population can sometimes make a substantial contribution to the results.

I don't have an opinion on whether or not it's relevant here because without publication in a journal, more details, and follow-up in different populations, it's not practical to form an opinion.

However, as with trials in China, if this multi-centre trial was located solely within Korea and with a Korean population, the distribution of rhesus factor as well as other blood antigens varies and this might have an impact on the outcomes of a vaccination trial.

You might have heard that rhesus -ve is referred to as panda blood in China because it's rare - if you look here, you'll see that it's a similar frequency in Korea (look at the pinkish 4 righthand columns): rhesusnegative.net/themissi...

If you compare that to other populations (e.g., Libya, UK) then there's a very different distribution.

It's one of the reasons that some modern trials are multi-centre in an international pattern.