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Incidence and Time Trends of Herpes Zoster in Rheumatoid Arthritis: A Population-Based Cohort Study
Article first published online: 30 MAY 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 6, pages 854–861, June 2013
How to Cite
Veetil, B. M. A., Myasoedova, E., Matteson, E. L., Gabriel, S. E., Green, A. B. and Crowson, C. S. (2013), Incidence and Time Trends of Herpes Zoster in Rheumatoid Arthritis: A Population-Based Cohort Study. Arthritis Care Res, 65: 854–861. doi: 10.1002/acr.21928
- Issue published online: 30 MAY 2013
- Article first published online: 30 MAY 2013
- Accepted manuscript online: 21 DEC 2012 12:00AM EST
- Manuscript Accepted: 6 DEC 2012
- Manuscript Received: 31 JUL 2012
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: Award R01-AR-46849
- National Institute on Aging. Grant Number: Award R01-AG-034676
- National Center for Advancing Translational Sciences. Grant Number: UL1-TR000135
To determine the incidence, time trends, risk factors, and severity of herpes zoster in a population-based cohort of patients with newly diagnosed rheumatoid arthritis (RA) compared to a group of individuals without RA from the same population.
All residents of Olmsted County, Minnesota fulfilling for the first time the 1987 American College of Rheumatology criteria for RA between January 1, 1980 and December 31, 2007 and a cohort of similar residents without RA were assembled and followed by retrospective chart review until death, migration, or December 31, 2008.
There was no difference in the presence of herpes zoster prior to the RA incidence/index date between the cohorts (P = 0.85). During followup, 84 patients with RA (rate 12.1 cases per 1,000 person-years) and 44 subjects without RA (rate 5.4 cases per 1,000 person-years) developed herpes zoster. Patients with RA were more likely to develop herpes zoster than those without RA (hazard ratio [HR] 2.4 [95% confidence interval (95% CI) 1.7–3.5]). Herpes zoster occurred more frequently in patients diagnosed with RA more recently (HR 1.06 per year [95% CI 1.02–1.10]). Erosive disease, previous joint surgery, and use of hydroxychloroquine and corticosteroids were significantly associated with the development of herpes zoster in RA. There was no apparent association of herpes zoster with the use of methotrexate or biologic agents. Complications of herpes zoster occurred at a similar rate in both cohorts.
The incidence of herpes zoster is increased in RA and has risen in recent years. There also has been an increasing incidence of herpes zoster in more recent years in the general population. RA disease severity is associated with the development of herpes zoster.