Lancet Article on Methotrexate and Pfizer/Biontech Vaccine Study

jamieA

The Lancet medical journal has published an article on the effect that taking Methotrexate has on the efficacy of the Pfizer vaccine. It’s based on a small study carried out in New York and Germany but appears to show that Methotrexate users have a reduced response to the Pfizer vaccine - 62% as opposed to over 90% in the general population.

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00212-5/fulltext

stickywicket

Thanks, Jamie. I'm pleased that UK is finally waking up to this. Of course, all studies so far are necessarily small but the USA does seem far more on the ball. This is the most comprehensive thing I've read, admittedly in National Geographic but it's usually a reliable source and the studies it references are from bona fide sources.

https://www.nationalgeographic.com/science/article/the-complex-situation-for-immunocompromised-people-and-covid-19-vaccines

Interestingly, they too seem to feel that methotrexate is more 'difficult' than the biologics, with the exception of rituximab. My medicalese isn't up to understanding all the whys and wherefores but I can understand enough to be grateful that I'm in Scotland which isn't - yet? - throwing caution, and face masks, to the wind

i've just, in the last half hour, had a reply to the email I sent to my MP a fortnight ago re information sharing so that others would be aware that many of us are not safe despite the vaccine. He has advised me to get vaccinated (??? I did in late January and March) and that there would be a UK study publishing some results later in the year.

Stephd

I sent the national geographic article to my Rheumatology nurse who found it very interesting. As far as I understand there is no clinical study yet on the efficacy of the vaccine for us except that we have been left out of studies so not to skew the results for the general population. I have asked GP and hospital if I could have an antibody test ahead of all Covid restrictions being lifted to establish if I have any antibodies at all but no luck. Has anyone had an antibody test? I would like it confirmed just to reinforce my stance on not changing anything next Monday and will continue to use a mask and keep socially distant from people. I am more anxious now than I was before. Very scary with Covid numbers rocketing.

Thanks Steph

jamieA

https://community.versusarthritis.org/discussion/comment/682774#Comment_682774

Steph,

The Lancet article is a bit of a hard read but it is about people with rheumatoid/psoriatic arthritis or psoriasis taking immunosuppressant drugs. I also found a BMJ article covering the same study which is a bit easier to read.

https://www.bmj.com/company/newsroom/methotrexate-users-have-a-reduced-immune-response-to-mrna-covid-19-vaccine/

The study only covers Pfizer/BIONTech mRNA vaccine and patients with immune-mediated inflammatory diseases (IMID) who may also be taking immunomodulatory medications - methotrexate, TNF and Interleukin - 17 and - 23

stickywicket

@jamieA Thanks for this. All info gratefully received especially the more easily understood type

@Stephd There was a post on Helplines about this by someone who had had an antigen test. It's on Page 4 and entitled (I think) vaccine response in immunosuppressed. It's by @Skap . It's not encouraging but, equally, from what I've read, antigen tests aren't particularly reliable as no-one is quite sure how to interpret them.

Yesterday, we entertained an old schoolfriend and her husband in the garden, of course. She's also on methotrexate and had been gallivanting all over throughout the pandemic. Vaccinated, of course. But, clearly, either she's protected or lucky.

jamieA

https://community.versusarthritis.org/discussion/comment/682810#Comment_682810

@stickywicket

Like you I'm in Scotland and concerned about the easing of restrictions. In the last week both my daughter's partners and my son's partner have been 'pinged' to tell them they had been close to someone who later tested positive. They had all fully returned to work in the past month. Thankfully they don't live with me so are keeping their distance. They have taken PCR tests and hopefully all is ok. My wife still works in respite support so is PCR tested weekly. We now kept a box of Lateral Flow Tests at home. I appreciate they aren't anywhere near as accurate but hopefully they are better than nothing.

I'm on 20mg Methotrexate and have had both Pfizer vaccinations so the details in this study leave me extremely wary. If almost 4 in 10 people on that combination do not generate sufficient antibodies to protect against Covid 19 then those aren't great odds.