Herpes zoster in patients treated with biologicals.
BACKGROUND
The incidence and severity of herpes zoster (HZ) appear increased in patients receiving tumor necrosis factor-α antagonists.


OBJECTIVE
To study the incidence and clinical features of HZ in 1,220 patients (4,206 patient-years) receiving either adalimumab, etanercept, infliximab, rituximab or ustekinumab.


RESULTS
Twenty-two HZ cases were identified [1.26% of total cohort; adalimumab: 11/1,546 patient-years, incidence rate (IR) 7.1; etanercept: 4/789 patient-years, IR 5.1; rituximab: 1/168 patient-years, IR 5.2; ustekinumab: 2/37 patient-years, IR 53.5; infliximab: 4/1,666 patient-years, IR 2.4]. The time to event varied widely (1.5- 108 months). Extensive HZ was reported in 45 and 32% of the cases, respectively. Persistent postzoster neuralgia (PHN; >6 months) was observed in 5/20 patients.


CONCLUSIONS
The HZ incidence was 2.1-fold higher among patients over 60 years, compared with a reference population, although not statistically significant. Severe, multidermatomal HZ and persistent PHN were common.
Department of Dermatology, University Hospital of Liège, and University of Liège, Liège, Belgium.
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V
Failla
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J
Jacques
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Castronovo
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AF
Nikkels
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy; D001688:Biological Products / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006562:Herpes Zoster / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000139:chemically induced* / Q000453:epidemiology; D011565:Psoriasis / Q000188:drug therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha