This guideline provides evidence-based recommendations on the use of vaccinations in children and adults with rheumatic and musculoskeletal diseases. It includes expanded indications for some vaccines, as well as guidance on whether to hold immunosuppressive medications or delay vaccination to maximize vaccine immunogenicity and efficacy.
How Long Should Methotrexate Be Held Following Seasonal Vaccinations?
Vaccinations against preventable diseases, including seasonal influenza, are strongly recommended for patients with rheumatoid arthritis (RA), who are at increased risk of infections as a result of underlying immune dysfunction and treatment-induced immunosuppression. Park et al. conducted this clinical trial to investigate whether discontinuing methotrexate for one week after seasonal influenza vaccination is noninferior to discontinuing it for two weeks after vaccination in patients with RA.
Gout & Excess Risk of Severe SARS-CoV-2 Infection
In this large, population-based study, Xie et al. found that the risks of SARS-CoV-2 infection, 30-day hospitalization and 30-day death were higher among individuals with gout than individuals without gout in the general population, irrespective of COVID-19 vaccination status.
Considering Benzbromarone as First-Line Therapy for Gout
In this comparative effectiveness clinical trial, Yan et al. set out to compare nontitrated, low-dose benzbromarone (not approved in the U.S.), a renal urate transporter 1 inhibitor, with low-dose febuxostat as the first-line therapy in gout patients with renal uric acid underexcretion.
Self-Initiated Care May Reduce Workforce Gap
Seppen et al. developed a smartphone application for patients with RA to assess the safety and efficacy of patient-initiated care, compared with usual care. By answering a weekly Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire, patients were able to monitor their own disease activity between clinic visits.
Patterns of Arthritis Flare
Similar patterns of inflammation occur in the joints of patients with inflammatory arthritis, but in each individual, arthritis affects only a subset of possible anatomic areas. Chang et al. set out to identify patient-specific anatomic patterns of joint flare to distinguish local from systemic drivers of chronic disease.
Sacroiliitis on MRI: axSpA or Another Cause?
Magnetic resonance imaging (MRI) is the gold standard imaging modality for the detection of sacroiliitis, a hallmark of axial spondyloarthritis (axSpA). However, the specificity of MRI for axSpA has been questioned. Renson et al. found that structural MRI-detected SI joint lesions are frequently seen in healthy individuals.

COVID-19 Vaccinations in Immune-Compromised Patients
A prospective observational study by Syversen et al. found that patients with immune-mediated inflammatory diseases (IMID) had an attenuated serologic response to the standard two-dose vaccine regimen but a third dose was safe and effective.
OA Prevalence Primarily on the Rise
Background & Objectives Worldwide, osteoarthritis (OA) is a highly prevalent, chronic joint disease that causes pain, disability and loss of function. Global trends demonstrated an increase of more than 100% in years lived with disability due to OA from 1990 to 2019. However, no nonsurgical intervention exists to prevent, halt or even delay OA progression….

Hand Osteoarthritis: Prevalence, Incidence and Progression
Eaton et al. set out to describe the prevalence, incidence and progression of radiographic and symptomatic hand osteoarthritis (OA), and to evaluate differences according to age, sex, race and other risk factors.
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