Table 3

Concerns about medication discontinuation around COVID-19 vaccination

NDisease flareWithdrawal effectsSide effects when previously stoppedUnsuccessful when previously stoppedMedication may no longer work as wellNo concerns
Systemic glucocorticoids762443 (58.1)188 (24.7)26 (3.4)28 (3.7)15 (2.0)62 (8.1)
NSAIDs740412 (55.7)18 (2.4)29 (3.9)13 (1.8)14 (1.9)254 (34.3)
Antimalarials733518 (70.7)24 (3.3)8 (1.1)8 (1.1)18 (2.5)157 (21.4)
Methotrexate855616 (72.0)13 (1.5)10 (1.2)3 (0.4)39 (4.6)174 (20.4)
Other csDMARDs*513372 (72.5)13 (2.5)6 (1.2)8 (1.6)19 (3.7)95 (18.5)
Mycophenolate228169 (74.8)8 (3.5)9 (4.0)2 (0.9)7 (3.1)33 (14.6)
Other antimetabolites†2111 (52.4)1 (4.8)1 (4.8)0 (0)1 (4.8)7 (33.3)
Abatacept7153 (74.6)3 (4.2)1 (1.4)0 (0)5 (7.0)9 (12.7)
Rituximab162131 (81.9)1 (0.6)3 (1.9)2 (1.3)7 (4.4)18 (11.3)
TNF inhibitors493369 (75.5)6 (1.2)5 (1.0)4 (0.8)73 (14.8)36 (7.4)
Other biologics‡206157 (77.3)4 (2.0)2 (1.0)3 (1.5)21 (10.2)19 (9.4)
JAK inhibitors121104 (86.0)2 (1.7)1 (0.8)0 (0)7 (5.8)7 (5.8)
IVIG10280 (79.2)2 (2.0)1 (1.0)1 (1.0)1 (1.0)17 (16.8)
  • *Includes apremilast, azathioprine, 6-mercaptopurine, leflunomide, sulfasalazine.

  • †Includes calcineurin inhibitors (ciclosporin, tacrolimus), cyclophosphamide, thalidomide and lenalidomide.

  • ‡Includes belimumab, IL-1 inhibitors (anakinra, canakimumab, rilonacept), IL-6 inhibitors (tocilizumab, sarilumab, siltuximab), IL-12/IL-23 inhibitors (ustekinumab, guselkumab), IL-17 inhibitors (secukinumab, ixekizumab), eculizumab, mepolizumab and vedolizumab.

  • csDMARDs, conventional synthetic DMARDs; DMARDs, drug-modifying antirheumatic drugs; IL, interleukin; IVIG, intravenous immunoglobulin; JAK, Janus kinase inhibitors; NSAIDs, non-steroidal anti-inflammatory drugs; TNF, tumour necrosis factor.