Rheumatoid Arthritis Associated With Higher Incidence of Herpes Zoster

Compared with the general population, patients with RA have an increased incidence of herpes zoster.

Compared with the general population, patients with rheumatoid arthritis (RA) were found to have a higher incidence of herpes zoster (HZ), according to study findings published in The Journal of Rheumatology.

Researchers conducted analysis study using data from Optum’s deidentified Clinformatics® Data Mart to study the incidence of HZ in patients with RA in the US between 2015 and 2020.

The RA (N=67,650) and control cohorts (N=11,401,743) were aged mean 64.8±12.7 and 53.5±19.0 years; 76.13% and 51.44% were men; and had a Charlson comorbidity index of 0.7±1.2 and 0.4±1.0 points, respectively.

A total of 3934 and 248,046 cases of HZ were recorded in the RA and non-RA cohorts, respectively. Herpes zoster had a higher incidence rate (IR) among patients with RA (IR, 21.5 per 1000 person-years [py]) than among the general population (IR, 7.6 per 1000 py).

When stratified by age, the rate of HZ in RA was highest among individuals aged 65 years and older (IR, 23.4 per 1000 py) and lowest among those aged between 18 and 29 years (IR, 5.4 per 1000 py).

This study found the overall IR of HZ to be nearly twice as high in patients with RA than in the general population after adjusting for differences in patient baseline characteristics…highlighting the significant burden of HZ in RA patients.

In the adjusted analysis, risk for HZ was significantly higher among patients with RA compared with the general population (adjusted incidence rate ratio [aIRR], 1.93; 95% CI, 1.87-1.99; P <.001) and among all age groups (aIRR, 1.34-2.59; all P <.001), except for those aged between18 and 29 years (aIRR, 1.47; 95% CI, 0.79-2.74; P =.226).

Stratified by therapy type, HZ rates were highest among patients receiving treatment with systemic steroids (IR, 27.7 per 1000 py), followed by Janus kinase (JAK) inhibitors (IR, 24.8 per 1000 py), biologics (IR, 20.8 per 1000 py), and disease-modifying antirheumatic drugs (DMARDs) alone or no treatment (IR, 16.2 per 1000 py).

The study authors concluded, “This study found the overall IR of HZ to be nearly twice as high in patients with RA than in the general population after adjusting for differences in patient baseline characteristics…highlighting the significant burden of HZ in [patients with] RA.”

Disclosure: This research was supported by GlaxoSmithKline Biologicals SA. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References:

Singer D, Thompson-Leduc P, Poston S, et al. Incidence of herpes zoster in patients with rheumatoid arthritis in the United States: a retrospective cohort study. J Rheumatol. Published online January 12, 2023. doi:10.3899/jrheum.220986