Methotrexate at a dose of ≤0.4 mg/kg/week or ≤ 20 mg/week
Leflunomide at a dose of ≤20 mg/daya
Corticosteroid at a dose of ≤20 mg/day (or 2 mg/kg/day for patients weighing < 10 kg) prednisone or equivalent
Corticosteroid at a dose of ≥20 mg/day (or > 2 mg/kg/day for patients weighing < 10 kg) prednisone or equivalent, for a period ≥14 days
bDMARD: biologic disease modifying anti-rheumatic drugs; As the dosage of serum level of leflunomide is difficult and the studies on the risk of vaccinating individuals taking leflunomide at the usual doses are lacked, in cases requiring vaccination, a drug elimination regimen of 8 g of cholestyramine 3 times/day for 11 days or 50 g of activated charcoal 4 times/day for 11 days must be prescribed (similar to Sanofi Pasteur Laboratory recommendation when a woman taking leflunomide become pregnant). If the leflunomide plasma level determination is available it is recommended to reach nondetectable levels (i.e., below 0.02 mg/l) before vaccination