Most Read Articles
15 Apr 2016
Addition of digoxin to an ACE inhibitor lessens heart failure (HF) hospitalisation in HF patients with reduced ejection fraction, regardless of diabetes status, as presented in an analysis of the Digitalis Investigation Group trial.
08 Sep 2017
Prediagnostic statin exposure appears to be associated with a significant reduction in breast cancer-specific mortality, with the survival benefit being more pronounced in women with oestrogen receptor (ER)-positive tumours, according to a study.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
06 Aug 2017
A recent study has shown the safety, efficacy and tolerance of fluoxetine for hypochondriasis. Moreover, joint treatment with both fluoxetine and cognitive behavioural therapy (CBT) confers a small incremental benefit over a single active treatment.

TNFi, corticosteroids up risk of herpes zoster in patients with RA

12 Jul 2017

The use of tumour necrosis factor inhibitor (TNFi) and higher dosage of corticosteroids appear to increase the incidence of herpes zoster in patients with rheumatoid arthritis (RA) in the clinical setting, according to a Japan study.

Researchers measured the crude incidence rate (IR) of herpes zoster treated with systemic antiviral medications in 1987 patients (median age 60.0 years; 81.5 percent female) from the Registry of Japanese Rheumatoid Arthritis Patients on Biologics for Longterm Safety (REAL) database.

To investigate the association between herpes zoster and medications, the authors performed a nested case–control study with 1:5 case-control pairs matched for age, sex, observation start year and comorbidity (herpes zoster group, n=43; control group, n=214).

A conditional logistic regression analysis was performed to calculate the odds ratio (OR) and 95 percent CI of the use of biological disease-modifying antirheumatic drugs (bDMARD), methotrexate (MTX) and corticosteroids for the occurrence of herpes zoster.

The median disease duration among participants was 6.0 years, and the crude IR of herpes zoster was 6.66 (95 percent CI, 4.92 to 8.83) per 1,000 person-years.

The ORs of medication use were 2.28 (1.09 to 4.76) for TNFi and 1.13 (1.03 to 1.23) for oral corticosteroid dosage (per 1 mg prednisolone increment), both of which were significantly increased. There were no increases in the ORs of non-TNFi and MTX usage.

These findings support the results of another study, which found that patients with RA taking specific immunosuppressive medication had an elevated risk of herpes zoster. Biologicals used correlated with severe herpes zoster occurrence. Researchers suggested the close monitoring and prevention of severe herpes zoster during specific immunosuppressive therapy. [BMJ Open 2017;7:e014032]

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Most Read Articles
15 Apr 2016
Addition of digoxin to an ACE inhibitor lessens heart failure (HF) hospitalisation in HF patients with reduced ejection fraction, regardless of diabetes status, as presented in an analysis of the Digitalis Investigation Group trial.
08 Sep 2017
Prediagnostic statin exposure appears to be associated with a significant reduction in breast cancer-specific mortality, with the survival benefit being more pronounced in women with oestrogen receptor (ER)-positive tumours, according to a study.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
06 Aug 2017
A recent study has shown the safety, efficacy and tolerance of fluoxetine for hypochondriasis. Moreover, joint treatment with both fluoxetine and cognitive behavioural therapy (CBT) confers a small incremental benefit over a single active treatment.