Background
- Seropositive inflammatory arthritis
Management
Initial
- Methotrexate
- Biologics
- Anti-TNF: adalimumab
- T-cell costimulatory inhibitor: abatacept
- IL-6 antagonist: tocilizumab
- IL-1 antagonist: anakinra
- B-cell depleting agents: rituximab
- JAK1/2/3 inhibitor: tofacitinib
Chronic
- Vaccination
- Can give dead vaccines: influenza, pneumococcus, HBV
- Can give live zoster vaccine with methotrexate but not biologics
- Avoid other live vaccines in both methotrexate and biologicals
