Pausing certain arthritis drugs after COVID-19 vaccination raises flare risk without improving antibody response
For patients with inflammatory arthritis, holding certain disease-modifying antirheumatic drugs (DMARDs), namely select biologic or Janus kinase inhibitor (JAKi) therapies, for two weeks at the time of a supplemental COVID-19 vaccine dose does not enhance humoral immunogenicity, according to a study published online Oct. 5 in JAMA Internal Medicine.
A study published in JAMA Internal Medicine on October 5, 2026, has found that temporarily stopping certain arthritis drugs called disease-modifying antirheumatic drugs (DMARDs), including select biologic or Janus kinase inhibitor (JAKi) therapies, at the time of a supplemental COVID-19 vaccine dose does not boost the body's antibody response.
However, it does raise the risk of a flare-up in patients with inflammatory arthritis. Jeffrey R. Curtis, M.D., M.P.H. of the University of Alabama at Birmingham led a study assigning 840 patients to either continue or stop their arthritis medication for two weeks following their next COVID-19 vaccine dose. The research showed no significant difference in antibody levels between the two groups, suggesting that stopping the medication does not enhance the immune response to the vaccine.
The authors concluded that there is no evidence to support routine temporary interruption of DMARD therapy for optimizing COVID-19 vaccine effectiveness in patients with inflammatory arthritis. The increased risk of flare-ups, particularly with JAKi therapies, outweighs any potential benefit, and therefore routine interruption is not recommended.
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