Increased risk of herpes zoster with tofacitinib treatment in Korean patients with rheumatoid arthritis: a single-center prospective study

Song, Yumi; Cho, Soo Kyung; Kim, Hyoungyoung; Kim, Hye Won; Nam, Eunwoo; Jeon, Jun Young; Yoo, Hyun–Jeong; Choi, Chan-Bum; Kim, So Yeon; Jun, Jae‐Bum; Bae, Sang‐Cheol; Yoo, Dae Hyun; Sung, Yoon Kyoung

doi:10.1038/s41598-023-33718-7

Cited by 1 publication

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References 28 publications

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“…The infection profiles of TNFis and JAKis have been found to be similar with regard to serious infections [9,10]. Compared with bDMARDs, JAKis were found to be more frequently associated with the development of HZ [6,11,12]. In patients with RA who received tofacitinib in two phase I, nine phase II, six phase III, and two long-term extension (LTE) studies, the crude incidence rate (IR) of HZ was found to be 4.0 (95% confidence interval [CI]: 3.7, 4.4) per 100 patient years (PY) [13].…”

Section: Introductionmentioning

confidence: 94%

Incidence Rates of Infections in Rheumatoid Arthritis Patients Treated with Janus Kinase or Interleukin-6 Inhibitors: Results of a Retrospective, Multicenter Cohort Study

Yoshida,

Miyata,

Suzuki

et al. 2024

JCM

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Objective: This study aimed to compare the incidence rates (IRs) of infections, including herpes zoster (HZ), in rheumatoid arthritis (RA) patients treated with Janus kinase inhibitors (JAKis) or interleukin-6 inhibitors (IL-6is). Methods: We retrospectively analyzed 444 RA patients treated using IL-6is (n = 283) or JAKis (n = 161). After adjusting for clinical characteristic imbalances by propensity score matching (PSM), we compared the IRs of infections including HZ between the JAKi and IL-6i groups. Results: Observational period: 1423.93 patient years (PY); median observational period: 2.51 years. After PSM, incidence rate ratios comparing JAKi with IL-6i were 3.45 (95% confidence interval [CI]: 1.48–9.04) for serious infections other than HZ indicating that the JAKi-treated group was more likely to develop serious infection than the IL-6i-treated group. Multivariate Cox regression analyses revealed that the use of prednisolone > 5.0 mg/day, coexisting interstitial lung disease (ILD), and diabetes mellitus (DM) were independent risk factors for serious infections. The crude IR for HZ was significantly higher in the JAKi group, but the difference between groups was not significant (IRR: 2.83, 95% CI: 0.87–10.96) in PSM analysis. Unadjusted and PSM analyses performed in our study showed increased IRs of serious infections in patients with RA treated with JAKis compared with those treated with IL-6is. Conclusions: The presence of ILD or DM and the use of prednisolone were found to be independent risk factors for serious infection in RA patients treated using JAKis. Whereas the IRs for HZ after PSM were not significantly different between the JAKi and IL-6i groups.

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