Shingles risk not boosted by TNF inhibitors in RA

Patients with rheumatoid arthritis who use anti-tumor necrosis factor (TNF) therapy are not at an increased risk of herpes zoster, according to a recent study.

Researchers from Oregon Health and Science University, Portland, compared the incidence of herpes zoster between 33,324 new anti-TNF users and 25,742 patients initiating nonbiologic disease-modifying antirheumatic drugs (DMARDS), according to the abstract. Investigators used Cox regression models to compare propensity score-adjusted herpes zoster incidence between the new anti-TNF and nonbiologic DRMARD users while also controlling for baseline corticosteroid use.

There were 310 shingles cases among the anti-TNF users, with crude incidence rates of 12.1 per 1,000 patient-years (95 percent confidence interval, 10.7-13.6) for rheumatoid arthritis. The incidence rates were 4.4 per 1,000 patient years for psoriasis and psoriatic arthritis. For patients with rheumatoid arthritis, the adjusted incidence rates were similar between the anti-TNF users and the nonbiologic DMARD initiators, researchers noted.

The study was published online March 6 in the Journal of the American Medical Association.