Herpes zoster in patients taking TNFα antagonists for chronic inflammatory joint disease - 09/10/08
, Gérald Streit, Eric Toussirot, Clément Prati
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Abstract |
Objective |
To assess the rate of occurrence and outcomes of herpes zoster in patients taking TNF
antagonists.
Methods |
Retrospective review of the medical records of 300 patients who received TNF 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 TNF antagonist. One patient experienced a recurrence after resuming TNF antagonist therapy.
Conclusion |
The scant data in the literature suggest a higher risk of herpes zoster with anti-TNF antibodies than with the soluble receptor. The role for concomitant treatments (glucocorticoids and methotrexate) should be taken into account.
Keywords : Herpes zoster, Rheumatoid arthritis, TNF antagonists
Plan
Vol 75 - N° 5
P. 540-543 - octobre 2008 Retour au numéro
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