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Methotrexate — SCE Dermatology MCQ

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ModerateDermatopharmacologyMethotrexateSCE Dermatology

A 55-year-old man with psoriasis on Methotrexate is planning to receive a COVID-19 vaccine. What is the BSR/BAD recommendation regarding Methotrexate and COVID-19 vaccination?

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Correct answer: B — Consider withholding Methotrexate for 2 weeks after each vaccine dose to optimise vaccine response

BSR/BAD COVID-19 vaccination guidance recommends considering withholding Methotrexate for 2 weeks after each COVID-19 vaccine dose (for all vaccine doses including boosters) to optimise vaccine immunogenicity. This recommendation balances the evidence that Methotrexate reduces antibody response to vaccines against the risk of disease flare during the drug-free period. The pause is recommended AFTER vaccination (not before). Patients should be counselled about possible eczema/psoriasis flare during the interruption. This guidance also applies to other non-live vaccines. Live vaccines are contraindicated during Methotrexate therapy.

Reference: BSR 2022 COVID Vaccination; BAD