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May 25, 2022
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Herpes zoster incidence higher among patients with IBD vs. general population

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SAN DIEGO — Patients with inflammatory bowel disease had a higher incidence of herpes zoster than the general population, demonstrating a need for preventive measures, according to research presented at Digestive Disease Week 2022.

“There is evidence to suggest that patients with ulcerative colitis and Crohn’s disease are at an increased risk for herpes zoster, which is a disease caused by the reactivation of the varicella zoster virus,” David Singer, PharmD, MS, director of U.S. health outcomes at GlaxoSmithKline, said. “Our study sought to estimate the incidence rate of herpes zoster in patients with IBD and to compare the incidence rate in patients with UC or CD to a number of patients without IBD.”

Crude incidence rates of herpes zoster per 1,000 person-years:

In a retrospective cohort study, Singer and colleagues compared incidence rates of herpes zoster (HZ) using data from a large U.S. administrative claims database between October 2015 and February 2020. Following 6 months of continuous enrollment and baseline data collection, they indexed patients who had at least 18 months of continuous enrollment by disease status and type. The final study population included 29,928 patients with UC (mean age, 60 years) and 25,959 patients with CD (mean age, 56 years); the general population comparator group included 11,839,329 individuals (mean age, 54 years).

Compared with the general population, Singer noted patients with IBD had a higher comorbidity burden as measured by the Charlson-Quan Comorbidity index (mean 0.8 vs. 0.4).

According to study results, crude incidence rates of HZ were 13.64 per 1,000 person-years in the UC group, 15.94 per 1,000 person-years in the CD group and 7.95 per 1,000 person-years in the general population. Stratified by age group, researchers observed the highest incidence rates among patients aged 65 years and older (16.32, 19.45 and 11.79 per 1,000 person-years for UC, CD and general population, respectively). Patients taking thiopurines, methotrexate and corticosteroids also had the highest crude incidence rates among medication classes.

Compared with the general population, the adjusted incidence rate ratios were 1.35 (95% CI, 1.26-1.44) for UC and 1.66 (95% CI, 1.56-1.77) for CD.

“Overall, the incidence rate of herpes zoster was increased in the UC and CD populations compared with the non-IBD population,” Singer concluded. “We also saw a relatively higher incidence rate of herpes zoster among younger age groups compared to those without IBD.”