Certain RA Medications Associated With Increased Risk for Herpes ZosterCHICAGO — February 17, 2009 — Use of monoclonal anti-tumor necrosis factor alpha (TNF-alpha) antibodies for the treatment of rheumatoid arthritis appears to be associated with an increased risk for herpes zoster, according to a study in the February 18 issue of JAMA.
There has been evidence from some studies that patients treated with anti-TNF-alpha agents are at an increased risk of bacterial infections, but little is known about the risk of viral infections in patients with rheumatoid arthritis receiving these types of medications.
Anja Strangfeld, MD, German Rheumatism Research Center, Berlin, Germany, and colleagues investigated the association of various rheumatoid arthritis treatments, including anti-TNF-alpha therapy, with the risk of herpes zoster.
The researchers analyzed data from patients who began treatment with adalimumab or infliximab, etanercept, anakinra, or when patients changed conventional disease-modifying anti-rheumatic drug (DMARD).
Treatment, clinical status, and adverse events were assessed by rheumatologists at fixed points during follow-up (of up to 3 years). A total of 5,040 patients were included in the analysis.
There were 86 cases of herpes zoster among 82 patients. Of the cases, 39 could be attributed to treatment with anti-TNF-alpha antibodies (23 to etanercept, 24 to conventional DMARDs).
The researchers found a significant association between herpes zoster and treatment with infliximab and adalimumab, although this risk was lower than the threshold for clinical significance. There was no significant association between herpes zoster and treatment with etanercept, or anti-TNF-alpha treatment as a class.
A significantly higher risk of developing herpes zoster was found for patients of older age and for treatment with glucocorticoids.
“Based on our data, we recommend careful monitoring of patients treated with monoclonal anti-TNF-alpha antibodies for early signs and symptoms of herpes zoster,” the authors concluded.
SOURCE: JAMA
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Certain RA Medications Associated With Increased Risk for Herpes Zoster
CHICAGO — February 17, 2009 — Use of monoclonal anti-tumor necrosis factor alpha (TNF-alpha) antibodies for the treatment of rheumatoid arthritis appears to be associated with an increased risk for herpes zoster, according to a study in the February 18 issue of JAMA.
There has been evidence from some studies that patients treated with anti-TNF-alpha agents are at an increased risk of bacterial infections, but little is known about the risk of viral infections in patients with rheumatoid arthritis receiving these types of medications.
Anja Strangfeld, MD, German Rheumatism Research Center, Berlin, Germany, and colleagues investigated the association of various rheumatoid arthritis treatments, including anti-TNF-alpha therapy, with the risk of herpes zoster.
The researchers analyzed data from patients who began treatment with adalimumab or infliximab, etanercept, anakinra, or when patients changed conventional disease-modifying anti-rheumatic drug (DMARD).
Treatment, clinical status, and adverse events were assessed by rheumatologists at fixed points during follow-up (of up to 3 years). A total of 5,040 patients were included in the analysis.
There were 86 cases of herpes zoster among 82 patients. Of the cases, 39 could be attributed to treatment with anti-TNF-alpha antibodies (23 to etanercept, 24 to conventional DMARDs).
The researchers found a significant association between herpes zoster and treatment with infliximab and adalimumab, although this risk was lower than the threshold for clinical significance. There was no significant association between herpes zoster and treatment with etanercept, or anti-TNF-alpha treatment as a class.
A significantly higher risk of developing herpes zoster was found for patients of older age and for treatment with glucocorticoids.
“Based on our data, we recommend careful monitoring of patients treated with monoclonal anti-TNF-alpha antibodies for early signs and symptoms of herpes zoster,” the authors concluded.
SOURCE: JAMA