Efficacy | Immunogenicity | LoE Immunogenicity | ||
Influenza | Pneumococcal | |||
MTX | No data | Adequate for influenza/reduced for pneumococcal | 2a | 2b |
Other cs-DMARD | No data | Only for HCQ Adequate | 4 | 4 |
Anti-TNFα | No data | Adequate | 2a | 2b |
B cell depletion | No data | Reduced | 2a | 2b |
Belimumab | No data | Pneumococcal: preserved | – | 2b |
Tocilizumab | No data | Preserved | 2b | 2b |
Abatacept | No data | Controversial Probably mildly reduced | 4 | 4 |
Tofacitinib | No data | Adequate for influenza, reduced for pneumococcal | 2b | 2b |
Glucocorticoids (±other IS) | No data | Adequate for influenza, mildly reduced in high doses GC for pneumococcal | 4 | 2b |
cs-DMARD, conventional synthetic disease-modifying antirheumatic drugs; GC, glucocorticoids; HCQ, hydroxychloroquine;IS, immunosuppressives; LoE, level of evidence; MTX, methotrexate; TNF, tumour necrosis factor.