Risk of herpes zoster in patients with rheumatoid arthritis in the biologics era from 2011 to 2015 and its association with methotrexate, biologics, and corticosteroids.

Abstract

OBJECTIVES:

To elucidate the incidence and risk factors of herpes zoster (HZ) in patients with rheumatoid arthritis (RA) in the biologics era.

METHODS:

We determined the rate of HZ occurrence among the RA patients that participated in the Institute of Rheumatology, Rheumatoid Arthritis surveys from 2011 to 2015, by assessing medical records. The standardised incidence rate per 1000 patient-years with a 95% confidence interval (CI) was calculated, and risk factors for HZ were analysed using a time-dependent Cox regression analysis.

RESULTS:

Among 7815 patients (female, 84.7%) contributing to 25,863 patient-years of observation, 340 HZ events in 309 patients were confirmed. The standardised incidence rate (95% CI) per 1000 patient-years was 8.5 (6.9-10.5) in total, 6.0 (3.7-9.2) in men, and 11.0 (8.7-13.7) in women. Risk factors for HZ were age per 10 years (hazard ratio 1.14, 95% CI 1.03-1.26, p < .05), Japanese version of the Health Assessment Questionnaire (J-HAQ) score of 0.5-1.5 (versus J-HAQ = 0; 1.51, 1.09-2.10, p < .05), methotrexate use (1.58, 1.06-2.36, p < .05), and biologic use (1.88, 1.44-2.47, p < .01).

CONCLUSIONS:

In the era when biologics were frequently used and corticosteroid use and doses were decreasing, methotrexate and biologics increased the risk for HZ.

• Authors: Rei Yamaguchi, Eiichi Tanaka, Ayako Nakajima, Eisuke Inoue, Mai Abe, Eri Sugano, Naohiro Sugitani, Kumiko Saka, Moeko Ochiai, Yoko Higuchi, Naoki Sugimoto, Katsunori Ikari, Hisashi Yamanaka, Masayoshi Harigai
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 32 Issue 3 Pg. 522-527 (Apr 18 2022) ISSN: 1439-7609 [Electronic] England
• PMID: 34897494 (Publication Type: Journal Article)
• Copyright: © Japan College of Rheumatology 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Adrenal Cortex Hormones
• Antirheumatic Agents
• Biological Products
• Methotrexate

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Antirheumatic Agents (adverse effects)
• Arthritis, Rheumatoid (complications, drug therapy, epidemiology)
• Biological Products (adverse effects)
• Child
• Female
• Herpes Zoster (epidemiology, etiology)
• Herpesvirus 3, Human
• Humans
• Male
• Methotrexate (adverse effects)