Berlin, Germany, June 7 2012: Patients with inflammatory rheumatic diseases (IRD) treated with anti-tumour necrosis factor medications (anti-TNFs) have a 75% greater risk of developing herpes zoster, or shingles, than patients treated with traditional disease modifying anti-rheumatic drugs (DMARDs), according to a meta-analysis presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism.
"Anti-TNFs, such as infliximab, adalimumab and etanercept have become the treatment of choice for patients with inflammatory rheumatic diseases who are uncontrolled on traditional DMARDs, but it is known that a side effect of these drugs is an increased risk of bacterial infections," said Ms. Helene Che, from Lapeyronie Hospital, France and lead author of the study. "This systematic review and meta-analysis demonstrates that careful monitoring of patients treated with anti-TNFs is required for early signs and symptoms of herpes zoster and raises the issue as to when vaccination against the virus should occur."
The study authors conducted a literature search in Medline, Embase, the Cochrane library and abstracts from ACR and EULAR congresses from 2006 to 2010. From the 657 articles, 134 congress abstracts, and 11 national registries included in the literature search, 22 articles and 28 abstracts met eligibility criteria and were included in the study. The meta-analysis included a total follow up of 124,966 patient years (PY) (74,198 PY in the biologics group and 50,768 PY in the DMARD group) across five registries.
Studies were included in the meta-analysis if they reported the respective incidences of herpes infection in anti-TNF and conventional DMARD treated patients. Incidence of severe herpetic infections (multidermatomal lesions, requiring hospitalisation or intravenous treatment) were excluded and reported when available.
Herpes zoster, also known as shingles, is a painful, blistering skin rash due to the varicella-zoster virus, the same virus that causes chickenpox . People are more likely to develop it if they are older than 60, had chickenpox before the age of one and have a compromised immune system due to medications or diseasei. Symptoms include one-sided pain, tingling or burning followed by a rash of small blisters, which eventually break, ulcer and dry upi. Other symptoms may include fever, chills, abdominal pain, swollen glands, difficulty moving muscles in the face, and drooping eyelidsi. Shingles is usually treated with antiviral medications to reduce pain and complications and corticosteroids to reduce swellingi. Pain from shingles can last for months or years, even though the infection normally lasts only two to three weeks. The virus can also cause temporary or permanent paralysis.*
Abstract Number: THU0368
*Netdoctor - Shingles (Herpes zoster). http://www.netdoctor.co.uk/diseases/facts/herpeszoster.htm 2011. Accessed 4 May 2012
NOTES TO EDITORS:
For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office in Hall 6 on the 3rd floor of the Congress Centre during EULAR 2012 or on:
Onsite tel: +44 7894 386 425
- The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations
- In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems
- EULAR aims to promote, stimulate and support the research, prevention, treatment and rehabilitation of rheumatic diseases. With 45 scientific member societies, 36 PARE organisations and 10 health professionals associations, EULAR underscores the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs
- Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer
- EULAR 2012 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 115 countries. Over the course of the congress, more than 275 oral and 1400 poster abstract presentations will be featured, with 1,010 invited speaker lectures taking place in 190 sessions
- To find out more about the activities of EULAR, visit: www.eular.org
Annals of the Rheumatic Diseases