Non-biologic immunomodulators
|
Corticosteroids
|
--/↓
|
--
|
ND
|
ND
|
Zoster OK with CCS <20 mg/day
|
Methotrexate
|
↓↓
|
↓
|
--
|
--
|
Zoster OK with MTX <0.4 mg/kg/week
|
Anti-malarials
|
--
|
--
|
ND
|
ND
|
Probably safe, possible ↓ response
|
Sulfasalazine
|
--/↓
|
ND
|
ND
|
ND
|
Probably safe, not formally studied
|
Leflunomide
|
--
|
ND
|
ND
|
ND
|
ND
|
Azathioprine
|
--
|
--/↓
|
ND
|
ND
|
Zoster OK <3 mg/kg/day
|
Mycophenolate
|
↓↓
|
↓↓
|
↓
|
↓
|
Avoid
|
Calcineurin Inhibitors
|
--/↓
|
ND
|
↓
|
ND
|
Avoid
|
Biologicals and targeted immunomodulators
|
TNF inhibitors
|
--/↓
|
--/↓
|
--
|
ND
|
Avoid
|
Abatacept (CTLA4-Ig)
|
↓
|
↓
|
ND
|
↓
|
Avoid
|
Rituximab (anti-CD20)
|
--/↓
|
↓↓
|
↓
|
↓↓
|
Avoid
|
Tocilizumab (anti-IL6)
|
--
|
--
|
ND
|
ND
|
Avoid
|
Ustekinumab (anti-IL-12/23)
|
--
|
--
|
ND
|
ND
|
Avoid
|
IL- 1 inhibitors (anakinra, Rilonacept, canakinumab)
|
ND
|
ND
|
ND
|
ND
|
Avoid
|
Belimumab (anti-BLyS)
|
ND
|
ND
|
ND
|
ND
|
Avoid
|
Tofacitinib (Jak1/3)
|
--/↓
|
↓
|
ND
|
ND
|
Avoid
|