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08-02-2022 | Rheumatology | News | Article

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Disease activity may be a risk factor for herpes zoster in RA patients taking JAK inhibitors

Author: Claire Barnard

medwireNews: Having several changes in targeted therapy and high disease activity are associated with an elevated risk for herpes zoster (HZ) among people with rheumatoid arthritis (RA) receiving treatment with Janus kinase (JAK) inhibitors, indicate study findings published in RMD Open.

Yoon-Kyoung Sung and colleagues, from Hanyang University Institute for Rheumatology Research in Seoul, South Korea, evaluated data from 61 RA patients diagnosed with HZ in 2011–2020 and 610 control RA patients matched by age and sex who did not develop HZ. In all, 27.9% of patients in the HZ group and 19.5% of controls received treatment with a JAK inhibitor, most commonly tofacitinib.

Multivariable analysis demonstrated that JAK inhibitor use was not associated with HZ risk after adjustment for confounding factors, but having at least three previous lines of targeted therapy was a significant predictor of HZ risk (adjusted odds ratio [OR]=5.29 vs no targeted therapy), while a disease duration of 10 years or more was significantly associated with reduced risk (adjusted OR=0.54).

“This might not mean that shorter duration of RA is a risk factor for HZ development, but rather that HZ development tends to occur during the early period of targeted therapy,” speculate the researchers.

When the analysis was restricted to patients taking JAK inhibitors, having three or more prior targeted therapies was again associated with increased HZ risk (adjusted OR=10.12), which the team suggests could be because “several changes in targeted therapy suggest insufficiently controlled disease activity.”

In support of this, higher DAS28-ESR (adjusted OR=1.44) was identified as an additional risk factor for HZ in JAK inhibitor-treated patients, supporting “the importance of controlled disease activity.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

RMD Open 2022; 8: e001892

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