Two-week interruption of MTX for IMIDs enhanced boost of antibody responses after COVID-19 vaccination, sustained at 12, 26 weeks. Consistent across ages, MTX doses, route, IMIDs, primary vaccination platform,COVID-19, Abhishek A Abst#1677 #ACR23 @RheumNow https://t.co/T0KdsGh6vg

VROOM 🏎️ study 2 wks interruption of MTX just after COVID vaccine: -Increase S1-RBD Ab response for 26 wks -Improves Neutralizing Ab titres (Wuhan Hu-1) -Leads to more flares wks 4 & 12 Greater effect when MTX dose>15mg @RheumNow #ACR23 ABST1677 https://t.co/SJmaRHtbRH

Abishek et al. 2 week break from MTX enhances response to COVID-19 vaccination, mirroring what we saw for flu. Trade off is short term worsening of disease activity. Abstr#1677 #ACR23 @RheumNow https://t.co/gguRWER81x https://t.co/1hncvDTahH

Abst#1583 SMART study: Split dose qwk MTX (10 mg QAM, 15 mg QPM) may have better efficacy compared to 25 mg single dose qwk MTX. RCT 253 RA patients: split dose had better DAS score, less likely to add other DMARDS, but slight⬆️in LFTs. #Plenary #ACR23 @rheumnow #ACRbest

Karpouzas et al. MTX reduces IHD in males but not females with RA. 4362 patients. 66% lower risk MACE and 55% lower risk any ischaemic CVE. Abstr#1627 #ACR23 @RheumNow https://t.co/MC4W0dinUv https://t.co/1hkBoawt4b

RA males 81% increase MACE & 58% ischemic CVE 2 folds Males>Females in MTX non users Makes MTX users reduction 66% & 55% risk MACE & ischemic CVE and no diff w/ females MTX use not assoc w/ reduction MACE in females @RheumNow #ACR23 ABST1627 https://t.co/qbAc2bWdcM

SMART study in RA, splitting MTX Split dosing better at wk 16 but ~similar at wk 24 Caveat: wonky design from wk16-wk24 makes it hard to interpret? Surprsingly, adverse events ~similar but smallish sample Mostly supports my practice of splitting? @RheumNow #ACR23 #ACRBest https://t.co/g7s4EUHeCW

SMART study - MTX split into morning and evening once weekly vs all together. 253 patients. Split dosing better efficacy (DAS28 4.1 vs 4.5, p=0.03), more LFT elevation but less neutropenia. Abstr#1583 #ACR23 @RheumNow https://t.co/tkrds4uqQP