This is 2nd antibody test I have taken after info from this site that the London Clinic perform these tests. (Expensive but to my mind worth it) The 2nd was after my 1st Pfizer BioNTech injection because I take a weekly 7.5mg dose of methotrexate.
The result was antibody positive @ 15.5 U/uL. I cannot find whether this figure is satisfactorily high or low but am just pleased I tested positive for antibodies. This time I have been advised by my rhuemy to stop mthx 2 weeks before my next 2nd jab and 2 weeks after. Anybody else had antibody test or advice regarding stopping mthx?
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Petel
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Safe to say that the advice regarding stopping medication in relation to vaccination varies wildly. I phoned my rheum nurse specialist line yesterday to chase a missing prescription and they now have a pre-recorded msg stating that no one needs to withhold any treatment either before or after covid vaccination. Other people here have been told to stop before, but not after, after but not before, after AND before...🤷♂️ I think the situation is that there’s currently no concrete information available about what’s required or necessary for those taking DMARDs, so whatever stance your particular team are taking (or you personally have been advised of) will be based on their clinical interpretation and opinion as to what’s best for patients, including on an individual basis where required. If they’re telling you to skip some doses, then that would be the advice to follow.
With regards to the antibody test, my understanding is that it’s extremely difficult to reliably quantify the degree of response someone has had, and there is currently only one quantitative antibody test available (made by Roche), hence why there are no guidance values to be found on the internet: we don’t yet know the significance of the values, and everyone’s immune system can respond slightly differently to invading organisms, so to some extent the view taken is simply that you either have antibodies, or you don’t, regardless of titre values using the Roche Elecsys test. Some of the variation in response can be age dependent, some of it can be sex dependent, some of it is health (and medication) dependent, plus time is a significant factor as the speed of antibody production and decay can vary between individuals.
Plus there are different types of antibodies, some are short term , some longer, some from vaccine, some from having covid so it depends on what test they did. And my nurse said when I went for my TCZ infusion, if you hadn't had your covid jab I would give you it now, plus your infusion. Only thing we are changing any timing on is rituximab.
To get a number result rather than just the positive or negative, it would have to be the Roche elecsys antibody test used, which is also currently the only test to measure ‘total antibody’, so it gives a figure for all covid antibodies found in a sample including IgG and IgM. It’s a validated test, but they are still trying to establish whether it’s more useful to measure it that way than looking for the specific presence of IgG, and/or IgM, or even spike protein. They’re also still unsure what role or value there is in looking at IgA in relation to covid immunity, but it’s often present in those who’ve had exposure. It’s a really interesting but extremely complex area - I never understand more than every other word of the papers 😬😂
Exactly as Charlie says re stopping drugs,...no consistency so follow advice from your medical team and your gut feeling. I stopped after both shots on advice of my rheumy.
The advice will vary as everyone is different - it will depend so much on your current disease state, treatment dosage etc. Stopping medication of any kind should only be done under the specific instructions of YOUR rheumatologist or specialist nurse who know YOUR disease profile and history. You will still get a response to the vaccine on or not on meds just the level of response may vary but not significantly as far as the evidence shows to date and response cannot be measured by antibody development alone.
Hope this helps to reassure. We are updating the NRAS website COVID section as quickly as possible with latest scientific evidence as it becomes available so do keep checking back every now and then as information is changing rapidly.
I realise that's the right approach but it isn't always possible to get personalised advice from your team.
My team is great at responding to messages left on the nurse helpline but the message on it says that their advice to all their patients is that it's safe to continue all RA medication with the vaccine and to only leave a message if you're on Rituxifan so I didn't feel that I could ask them.
As my disease is well-controlled atm I took the personal decision to pause my Metoject for one week when I had the first vaccination a few weeks ago and interestingly, I mentioned that to the rheumy nurse when we were discussing possible Methotrexate side effects last week and she didn't take me up on it....
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