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Anti-TNF Therapy Not Linked to Herpes Zoster Risk in RA
Findings among patients with rheumatoid arthritis and other inflammatory diseases

TUESDAY, March 5 (HealthDay News) -- For patients with rheumatoid arthritis (RA) and other inflammatory diseases, use of anti-tumor necrosis factor (TNF) therapy is not associated with an increased risk of herpes zoster, according to a study published in the March 6 issue of the Journal of the American Medical Association.

Kevin L. Winthrop, M.D., M.P.H., from the Oregon Health and Science University in Portland, and colleagues compared the risk of herpes zoster among 33,324 new anti-TNF users and 25,742 patients initiating non-biologic disease-modifying antirheumatic drugs (DMARDS) with RA; inflammatory bowel disease; and psoriasis, psoriatic arthritis, or ankylosing spondylitis, from 1998 through 2007.

The researchers found that there were 310 cases of herpes zoster among the new users of anti-TNF therapy. Among anti-TNF users, the crude incidence rates for herpes zoster were 12.1, 11.3, and 4.4 per 1,000 patient-years for patients with RA; inflammatory bowel disease; and psoriasis, psoriatic arthritis, or ankylosing spondylitis. Among all disease indications, baseline use of corticosteroids of 10mg/day or more versus no baseline use correlated with increased risk (adjusted hazard ratio, 2.13). For patients with RA, the adjusted incidence rates were not significantly different for patients who initiated anti-TNF or DMARD agents. Across all disease indications there was no significantly increased risk of herpes zoster (adjusted hazard ratio, 1.09; 95 percent confidence interval, 0.88 to 1.36).

"In summary, among patients with RA and other select inflammatory diseases, those who initiated anti-TNF therapies were not at higher risk of herpes zoster compared with patients who initiated non-biologic treatment regimens," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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