MMRV Safety Assessed in Children on Methotrexate, Dupilumab

TOPLINE:

A retrospective analysis finds no adverse events (AEs) in children receiving a live attenuated vaccine against measles, mumps, rubella, and varicella (MMRV) while on dupilumab or methotrexate treatment, challenging current recommendations.

METHODOLOGY:

• Researchers conducted a retrospective search of electronic medical records at a pediatric tertiary care center between 2017 and 2023, identifying patients who received dupilumab or methotrexate for allergic or dermatologic concerns.
• The analysis included pediatric patients who received live attenuated vaccines within 6 weeks before initiating or up to 6 weeks after ending treatment with either medication.
• A manual chart review was performed to document any treatment-emergent AEs (TEAEs) for up to 6 months postvaccination.

TAKEAWAY:

• A total of 313 pediatric patients who were treated with dupilumab or methotrexate during the study period were identified.
• Five patients received an MMRV vaccine while on dupilumab, and four received it while on methotrexate treatment.
• No associated AEs were observed for up to 6 months following immunization in any of the nine vaccinated patients.

IN PRACTICE:

“Larger, prospective studies are needed to establish evidence-based recommendations for safe and effective use of live virus vaccines in children treated with methotrexate, dupilumab, and other medications impacting immune function,” the authors wrote.

SOURCE:

The study was led by Julia R. Hughes, Saint Louis University School of Medicine, St. Louis, Missouri. It was published online on December 11 in Pediatric Dermatology.

LIMITATIONS: 

Limitations included the small number of evaluable patients, limited access to the records of vaccine administration outside the study center, and the retrospective nature of TEAE evaluation restricted to the documented events in electronic medical records. The analysis would not capture AEs occurring outside the study center or partner institutions and minor AEs not requiring medical attention.

DISCLOSURES:

The authors received no specific funding for this study. One author reported being a consultant, serving on data and safety monitoring boards, and acting as a clinical study investigator for various pharmaceutical companies. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.