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Steroid dose, TNFi use linked to increased risk of herpes zoster in patients with RA
Use of tumor necrosis factor inhibitors and a higher dose of corticosteroids correlated with an increased risk for herpes zoster in patients with rheumatoid arthritis, according to recently published data from Japan.
Masayoshi Harigai, MD, PhD, at Tokyo Women’s Medical University, and colleagues assessed 1,987 patients diagnosed with rheumatoid arthritis (RA) between 2005 and 2012 who met the 1987 American College of Rheumatology criteria for the disease. Of the 1,987 patients, 672 completed the fifth and final year of the study. Overall, 81.5% were women; the average age was 60 years; and the median disease duration was 6 years. For the 43 patients who developed herpes zoster, there were five controls matched by age, gender, comorbidity and observation start year.
Investigators found there was an increased risk for herpes zoster for patients who used tumor necrosis factor inhibitors (TNFi) compared with those who did not use TNFi (ratio = 2.28). In addition, there was an increased risk for herpes zoster per 1-mg incremental increase in dose of oral prednisolone (ratio = 1.13). However, there was no increased risk for herpes zoster with the use of methotrexate or non-TNFi disease-modifying antirheumatic drugs.
“Our results suggest that careful monitoring for [herpes zoster] HZ is necessary in patients with RA using these drugs,” the researchers wrote. – by Will A. Offit
Disclosures: Harigai reports he received honoraria from Mitsubishi Tanabe Pharma Co. Please see the full study for a list of all other authors’ relevant financial disclosures.