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Comparative Study
. 2013 Jun;65(6):854-61.
doi: 10.1002/acr.21928.

Incidence and time trends of herpes zoster in rheumatoid arthritis: a population-based cohort study

Bharath Manu Akkara Veetil  1 , Elena Myasoedova, Eric L Matteson, Sherine E Gabriel, Abigail B Green, Cynthia S Crowson
Affiliations
Comparative Study

Incidence and time trends of herpes zoster in rheumatoid arthritis: a population-based cohort study

Bharath Manu Akkara Veetil et al. Arthritis Care Res (Hoboken). 2013 Jun.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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Figures

Figure 1
Figure 1
Cumulative incidence of herpes zoster in RA vs. non-RA. Solid line are patients with RA and dashed line are subjects without RA (p<0.001).
Figure 2
Figure 2
The incidence of herpes zoster by calendar year of follow-up in patients with RA compared to subjects without RA. Solid line is RA and dashed line is non-RA.
See this image and copyright information in PMC

References

    1. Gnann JW, Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5):340–6. - PubMed
    1. Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis. 2004;4(1):26–33. - PubMed
    1. Smitten AL, Choi HK, Hochberg MC, Suissa S, Simon TA, Testa MA, et al. The risk of herpes zoster in patients with rheumatoid arthritis in the United States and the United Kingdom. Arthritis Rheum. 2007;57(8):1431–8. - PubMed
    1. Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, et al. Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents. Jama. 2009;301(7):737–44. - PubMed
    1. Melton LJ., 3rd History of the Rochester Epidemiology Project. Mayo Clin Proc. 1996;71(3):266–74. - PubMed

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