Risks of Immunosuppressive Therapies in Patients With RA: Herpes Zoster

Risks of Immunosuppressive Therapies in Patients With RA: Herpes Zoster

Automated medical, claims, and pharmacy records of a health maintenance organization were used to identify cases of PHN and obtain data on risk factors. It manifests as a unilateral cutaneous dermatitis with a prodromal fever and malaise. Stroke risk may be increased following zoster, but evidence is sparse and could be explained by differences between people with and without zoster. The risk for stroke/TIA after HZ was compared with HZ-free stroke/TIA individuals according to age group. The most common complication is postherpetic neuralgia. Results Of 29,129 new biologic treatment episodes, 28.7% used abatacept, 15.9% adalimumab, 14.8% rituximab, 12.4% infliximab, 12.2% etanercept, 6.1% tocilizumab, 5.8% certolizumab, and 4.4% golimumab. Among the 6,584 patients included in the study, the stroke rate was 63 percent higher in the first four weeks after a shingles episode compared to the patient’s baseline risk, diminishing slowly up to 6 months later.

Risks of Immunosuppressive Therapies in Patients With RA: Herpes Zoster
Inhaled corticosteroid (ICS) exposure included prescriptions for beclometasone, budesonide, triamcinolone, fluticasone and flunisolide, whether dispensed alone or in a combination inhaler with an inhaled β agonist. Among the 6,584 patients included in the study, the stroke rate was 63 percent higher in the first four weeks after a shingles episode compared to the patient’s baseline risk, diminishing slowly up to 6 months later. Study the educational content online or printed out. For those on doses above 7.5 mg per day, the hazard ratio was 2.35 (95% CI 1.81-3.04), and for those on lower doses the hazard ratio was 1.55 (95% CI 1.25-1.94). PHN causes physical disability, emotional distress and interference with daily activities and sleep.5 HZ also causes neurological sequelae, HZ ophthalmicus (HZO) with eye involvement or disseminated disease. The associations between shingles and rheumatoid arthritis/SLE have been reported in many medical articles [10–13]. You may now view or print the certificate from your CME/CE Tracker.

You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing “Edit Your Profile” at the top of your Medscape homepage. *The credit that you receive is based on your user profile. The low antiviral prescribing rate needs to be improved; our data suggest that antiviral therapy may lead to a reduced stroke risk following zoster. Physicians should only claim credit commensurate with the extent of their participation in the activity. Take 4 tablespoons of the mixture and put it into 1 liter of water. Glucocorticoid use had a significant association with HZ.

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