Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Live zoster vaccine confers limited protection during tofacitinib therapy

Key clinical point: Patients with RA given the live attenuated zoster vaccine (Zostavax) are still at risk for shingles during tofacitinib therapy.

Major finding: With 27-months’ follow-up, 5% of patients vaccinated before starting tofacitinib nonetheless developed herpes zoster.

Study details: An open-label, long-term extension study involving 100 patients with RA aged ≥50 years who were vaccinated before starting tofacitinib.

Disclosures: The study was sponsored by Pfizer. Dr. Winthrop disclosed consulting for AbbVie, Bristol-Myers Squibb, Eli Lilly, Galapagos, Gilead, Pfizer, and UCB and receiving grant/research support from Bristol-Myers Squibb. Two coauthors disclosed financial relationships with Pfizer and other pharmaceutical companies, and the other seven coauthors were employees and shareholders of Pfizer.


Winthrop KL et al. Ann Rheum Dis. 2020 Mar 11. doi: 10.1136/annrheumdis-2019-216566.