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Anti-TNF Therapy and Risk of Shingles

Article: Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster. JAMA. 2013;309(9):887-895.

Summary

New study looks at whether a therapy for rheumatoid arthritis and other inflammatory diseases increases the risk of shingles.

Abstract

Importance Herpes zoster reactivation disproportionately affects patients with rheumatoid arthritis (RA). It is unclear whether anti–tumor necrosis factor (anti‑TNF) therapy elevates herpes zoster risk.

Objectives To ascertain whether initiation of anti‑TNF therapy compared with nonbiologic comparators is associated with increased herpes zoster risk.

Design, Setting, and Patients We identified new users of anti‑TNF therapy among cohorts of patients with RA, inflammatory bowel disease, and psoriasis, psoriatic arthritis, or ankylosing spondylitis from 1998 through 2007 within a large US multi‑institutional collaboration combining data from Kaiser Permanente Northern California, Pharmaceutical Assistance Contract for the Elderly, Tennessee Medicaid, and national Medicaid/Medicare programs. We compared herpes zoster incidence between new anti‑TNF users (n=33,324) and patients initiating nonbiologic disease‑modifying antirheumatic drugs (DMARDs) (n=25 742) within each inflammatory disease cohort (last participant follow‑up December 31, 2007). Within these cohorts, we used Cox regression models to compare propensity score‑adjusted herpes zoster incidence between new anti‑TNF and nonbiologic DMARD users while controlling for baseline corticosteroid use.

Main Outcome Measures Incidence of herpes zoster cases occurring after initiation of new anti‑TNF or nonbiologic DMARD therapy.

Results Among 33 324 new users of anti‑TNF therapy, we identified 310 herpes zoster cases. Crude incidence rates among anti‑TNF users were 12.1 per 1000 patient‑years (95% CI, 10.7‑13.6) for RA, 11.3 per 1000 patient‑years (95% CI, 7.7‑16.7) for inflammatory bowel disease, and 4.4 per 1000 patient‑years (95% CI, 2.8‑7.0) for psoriasis, psoriatic arthritis, or ankylosing spondylitis. Baseline use of corticosteroids of 10 mg/d or greater among all disease indications was associated with elevated risk (adjusted hazard ratio [HR], 2.13 [95% CI, 1.64‑2.75]) compared with no baseline use. For patients with RA, adjusted incidence rates were similar between anti‑TNF and nonbiologic DMARD initiators (adjusted HR, 1.00 [95% CI, 0.77‑1.29]) and comparable between all 3 anti‑TNF therapies studied. Across all disease indications, the adjusted HR was 1.09 (95% CI, 0.88‑1.36).

Conclusion and Relevance Among patients with RA and other inflammatory diseases, those who initiated anti‑TNF therapies were not at higher risk of herpes zoster compared with patients who initiated nonbiologic treatment regimens.

Interview with Kevin L. Winthrop, MD, MPH, author of Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster.

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Terapia anti-FNT y riesgo de herpes zóster

Artículo: Asociación entre el inicio del tratamiento anti-factor de necrosis tumoral y el riesgo de herpes zóster. JAMA. 2013;309(9):887-895.

Summary

En un nuevo estudio se examina si el tratamiento contra la artritis reumatoide y otras enfermedades inflamatorias aumentan el riesgo de herpes zóster.

Entrevista con Kevin L. Winthrop, MD, MPH, autor de Asociación entre el inicio del tratamiento anti-factor de necrosis tumoral y el riesgo de herpes zóster.

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Traitement anti-TNF et risque de zona

Article: Association entre l'instauration d'un traitement par anti-facteur de nécrose tumorale et le risque de zona. JAMA. 2013;309(9):887-895.

Summary

Une nouvelle étude détermine si l'instauration de ce traitement en cas de polyarthrite rhumatoïde ou d'autres maladies inflammatoires induit un risque accru de zona.

Entretien avec Kevin L. Winthrop, MD, MPH, auteur de Association entre l'instauration d'un traitement par anti-facteur de nécrose tumorale et le risque de zona.

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Terapia anti-TNF e rischio di herpes zoster

Articolo: Associazione tra l'avvio della terapia anti-fattori di necrosi tumorale (TNF) e il rischio di herpes zoster. JAMA. 2013;309(9):887-895.

Summary

Un nuovo studio analizza se una terapia per l'artrite reumatoide e altre malattie infiammatorie aumenta il rischio di herpes zoster.

Intervista a Kevin L. Winthrop, MD, MPH, autore di Associazione tra l'avvio della terapia anti-fattori di necrosi tumorale (TNF) e il rischio di herpes zoster.

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抗 TNF 治疗与带状疱疹发病风险

文章: 抗肿瘤坏死因子治疗与带状疱疹发病风险之间的关联。 JAMA. 2013;309(9):887-895.

Summary

项新研究评估了类风湿性关节炎及其他炎症性疾病的一种治疗方案是否会增加带状疱疹的发病风险。

专访 Kevin L. Winthrop, MD, MPH, 作者 抗肿瘤坏死因子治疗与带状疱疹发病风险之间的关联。

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Anti-TNF Therapy and Risk of Shingles

статья: Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster. JAMA. 2013;309(9):887-895.

Summary

Перевод отсутствует.

Интервью с Kevin L. Winthrop, MD, MPH автор Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster.

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Anti-TNF Therapy and Risk of Shingles

Artigo: Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster. JAMA. 2013;309(9):887-895.

Summary

Não há tradução disponível.

Entrevista com o Kevin L. Winthrop, MD, MPH autor de Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster.

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Anti-TNF-Therapie und Risiko einer Gürtelrose

Artikel: Zusammenhang zwischen der Einführung der Anti-Tumor-Nekrose-Faktor-Therapie und dem Risiko einer Gürtelrose. JAMA. 2013;309(9):887-895.

Summary

Eine neue Studie untersucht, ob eine Therapie von rheumatoider Arthritis und anderer entzündlicher Erkrankungen das Risiko einer Gürtelrose erhöht.

Interview mit Kevin L. Winthrop, MD, MPH, autor Zusammenhang zwischen der Einführung der Anti-Tumor-Nekrose-Faktor-Therapie und dem Risiko einer Gürtelrose.

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