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Patients with rheumatoid arthritis (RA) often receive therapies that include JAK inhibitors, including tofacitinib (Xeljanz). However, studies have shown excess risk for herpes zoster (HZ) in patients who receive tofacitinib. In this study, researchers used the MarketScan and Medicare databases to determine how risk for shingles varied among 8000 tofacitinib-treated patients, according to concomitant use of methotrexate or glucocorticoids.
Incidence of HZ was lowest among patients who did not take glucocorticoids, regardless of concomitant methotrexate use (≈3 cases per 100 patient-years). Incidence of HZ was approximately twofold higher among tofacitinib users who took glucocorticoids, whether or not they also took methotrexate (≈6 cases pe…