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Joint Bone Spine. 2008 Oct;75(5):540-3. doi: 10.1016/j.jbspin.2007.10.011. Epub 2008 Jul 31.

Herpes zoster in patients taking TNFalpha antagonists for chronic inflammatory joint disease.

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  • 1Service de Rhumatologie, CHU Minjoz et Université de Franche-Comté, 25030 Besançon, France. dwendling@chu-besancon.fr

Abstract

OBJECTIVE:

To assess the rate of occurrence and outcomes of herpes zoster in patients taking TNFalpha antagonists.

METHODS:

Retrospective review of the medical records of 300 patients who received TNFalpha antagonists to treat chronic inflammatory joint disease.

RESULTS:

We identified 9 (9/300, 3%) patients who experienced herpes zoster, 6 women and 3 men, with rheumatoid arthritis (n=7) or ankylosing spondylitis (n=2). The drug was infliximab in 4 patients, adalimumab in 2 patients, and etanercept in 3 patients, including 2 patients with a prior history of infliximab therapy (for 12 and 36 months, respectively). Mean treatment duration at the occurrence of herpes zoster was 27 months (range, 6-42 months).

DISCUSSION:

Glucocorticoid therapy (n=7) and methotrexate therapy (n=6) were the only risk factors identified in our study. Mean follow-up was 26 months. All 9 patients achieved a full recovery with antiviral treatment and interruption of the TNFalpha antagonist. One patient experienced a recurrence after resuming TNFalpha antagonist therapy.

CONCLUSION:

The scant data in the literature suggest a higher risk of herpes zoster with anti-TNFalpha antibodies than with the soluble receptor. The role for concomitant treatments (glucocorticoids and methotrexate) should be taken into account.

PMID:
18674945
[PubMed - indexed for MEDLINE]
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