Herpes Zoster in Arthritis Patients Who Take Anti-TNF-α Agents

Excess risk with infliximab and adalimumab but not with etanercept

Patients treated with tumor necrosis factor–α antagonists (anti-TNF-α; e.g., infliximab, adalimumab, etanercept) are at risk for bacterial infections (JW Apr 10 2007); anecdotally, risk for herpes zoster (HZ) also seems to rise. In a prospective cohort study (funded by several manufacturers of anti-TNF-α agents), German investigators assessed HZ risk in 5040 patients with rheumatoid arthritis (RA) who were treated with either anti-TNF-α or standard disease-modifying antirheumatic drugs (DMARDs).

Eighty-six episodes of HZ occurred during 3 years of follow-up. In an analysis adjusted for age, RA severity, and glucocorticoid use, patients who received infliximab or adalimumab had significantly elevated risk for HZ (hazard ratio, 1.82); those wh…

Reviewing Author

Thomas L. Schwenk, MD

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Thomas L. Schwenk, MD

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Herpes Zoster in Arthritis Patients Who Take Anti-TNF-α Agents

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Reviewing Author