From the Guidelines
After stopping Rinvoq (upadacitinib), you should wait at least 3 months before receiving any live vaccines, as this allows sufficient time for the medication to clear from your system and for your immune function to recover, thereby minimizing the risk of infection from the vaccine itself 1. Rinvoq is a JAK inhibitor that suppresses the immune system, which can reduce your body's ability to respond appropriately to live vaccines. Examples of live vaccines include measles-mumps-rubella (MMR), chickenpox (varicella), yellow fever, and the nasal spray flu vaccine (FluMist).
It's essential to inform your healthcare provider about your recent use of Rinvoq before receiving any vaccinations. If you're uncertain whether a specific vaccine is live or inactivated, consult with your healthcare provider or pharmacist. Additionally, if you have other conditions affecting your immune system, your doctor might recommend a longer waiting period. The decision to administer any live vaccine should be considered on a case-by-case basis, taking into account the individual's immune status and the potential risks and benefits of vaccination 1.
Some studies suggest that the ideal time to review a patient’s immunization status is at diagnosis, and regular follow-up is necessary to ensure that patients are appropriately immunized 1. However, the key consideration is the timing of live vaccine administration after stopping immunosuppressive therapy, and the most recent and highest-quality evidence recommends a waiting period of at least 3 months 1.
Key points to consider:
- Rinvoq (upadacitinib) is a JAK inhibitor that suppresses the immune system
- Live vaccines should be avoided after stopping immunosuppressive therapy until the immune system has recovered
- The recommended waiting period after stopping Rinvoq is at least 3 months before receiving any live vaccines 1
- Examples of live vaccines include MMR, chickenpox, yellow fever, and the nasal spray flu vaccine
- It's crucial to inform your healthcare provider about your recent use of Rinvoq before receiving any vaccinations.
From the Research
Live Vaccine Administration After Stopping Rinvoq (Upadacitinib)
There are no specific studies that directly address when a live vaccine can be administered after stopping Rinvoq (upadacitinib). However, the following information can be considered:
- The studies 2, 3, 4 discuss the safety and efficacy of live attenuated vaccines in patients receiving immunosuppressive agents, but do not provide specific guidance on the timing of live vaccine administration after stopping a particular immunosuppressive medication like Rinvoq.
- The study 2 suggests that live vaccinations under most immunosuppressive treatments should only be administered after a careful risk-benefit assessment of medications and dosages.
- The studies 3, 4 provide evidence that live attenuated vaccines can be used in patients receiving immunosuppressants, but emphasize the need for further research to determine the conditions for safe use.
Key Considerations
- The decision to administer a live vaccine after stopping Rinvoq should be made on a case-by-case basis, taking into account the individual patient's immune status and medical history.
- The following factors may be considered:
- The patient's immune function and ability to respond to the vaccine
- The risk of infection and the potential benefits of vaccination
- The timing and dosage of the immunosuppressive medication
- The specific vaccine being considered and its potential risks and benefits
Available Data
- The studies 5, 6 provide information on vaccine immunogenicity and recommendations for vaccinations in specific patient populations, but do not directly address the question of when a live vaccine can be administered after stopping Rinvoq.
- The study 5 suggests that live vaccine immunization may not need to be delayed for as long as currently recommended after red blood cell transfusion.
- The study 6 provides recommendations for vaccinations in asplenic and hyposplenic adult patients, but does not address the specific question of live vaccine administration after stopping Rinvoq.