Dr. Smitten has received consultant fees (more than $10,000) from Bristol-Myers Squibb.
The risk of herpes zoster in patients with rheumatoid arthritis in the United States and the United Kingdom
Article first published online: 29 NOV 2007
Copyright © 2007 by the American College of Rheumatology
Arthritis Care & Research
Volume 57, Issue 8, pages 1431–1438, 15 December 2007
How to Cite
Smitten, A. L., Choi, H. K., Hochberg, M. C., Suissa, S., Simon, T. A., Testa, M. A. and Chan, K. A. (2007), The risk of herpes zoster in patients with rheumatoid arthritis in the United States and the United Kingdom. Arthritis & Rheumatism, 57: 1431–1438. doi: 10.1002/art.23112
- Issue published online: 29 NOV 2007
- Article first published online: 29 NOV 2007
- Manuscript Accepted: 4 JUN 2007
- Manuscript Received: 6 OCT 2006
- Harvard Pharmacoepidemiology Program
- Bristol-Myers Squibb Company
- Herpes zoster;
- Rheumatoid arthritis
To determine whether the incidence of herpes zoster is elevated in patients with rheumatoid arthritis (RA) and whether herpes zoster is associated with use of disease-modifying antirheumatic drugs (DMARDs) in patients with RA.
Two retrospective cohort studies were conducted using data from a US integrated managed care database (PharMetrics claims database) from 1998–2002 and the UK General Practice Research Database (GPRD) between 1990–2001. Rates of herpes zoster among patients with RA and randomly sampled non-RA patients were compared. A nested case–control analysis was performed within each RA cohort to examine the effect of current treatment on herpes zoster risk.
A total of 122,272 patients with RA from the PharMetrics database and 38,621 from the GPRD were included. The adjusted hazard ratios of herpes zoster for patients with RA compared with non-RA patients were 1.91 (95% confidence interval [95% CI] 1.80–2.03) in the PharMetrics database and 1.65 (95% CI 1.57–1.75) in the GPRD. In the PharMetrics database, current use of biologic DMARDs alone was associated with herpes zoster (odds ratio [OR] 1.54, 95% CI 1.04–2.29), as was current use of traditional DMARDs alone (OR 1.37, 95% CI 1.18–1.59). In the GPRD, current use of traditional DMARDs was associated with herpes zoster (OR 1.27, 95% CI 1.10–1.48). In both data sources, use of oral corticosteroids was associated with herpes zoster regardless of concomitant therapies.
Data from 2 large databases suggested that patients with RA are at increased risk of herpes zoster. Among patients with RA, DMARDs and/or use of oral corticosteroids appeared to be associated with herpes zoster.