Risk of Herpes zoster in patients with psoriasis treated with biologic drugs

Dreiher, Jacob; Kresch, F.S.; Comaneshter, Doron; Cohen, Arnon D.

doi:10.1111/j.1468-3083.2011.04230.x

Cited by 51 publications

(66 citation statements)

References 26 publications

(98 reference statements)

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“…A retrospective cohort study in Israel among psoriasis patients found zoster incidence was higher among patients treated with biologics such as infliximab (19.1 per 1000-person-years) compared to patients not on systemic therapy (4.6 per 1000 personyears) [21], but the difference in incidence did not reach statistical significance. Data from registries of patients with rheumatic diseases treated with biological agents in Spain [22], Germany [23], and France [24] suggest an increased risk of zoster when these patients are treated with monoclonal antibody-tumor necrosis factor (TNF) inhibitors.…”

Section: Incidence Among Immunosuppressedmentioning

confidence: 99%

The Epidemiology and Prevention of Herpes Zoster

2012

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Herpes zoster is a common disease among older individuals, affecting approximately 25% of people in their lifetime and resulting in appreciable morbidity. The risk of zoster increases sharply with age and immunosuppression, yet relatively little is known about other risk factors for zoster. A vaccine for zoster is now available that holds the potential to reduce incidence of zoster and its complications. In this review, the recent literature on zoster incidence and potential risk factors for the disease are summarized. Current methods of preventing zoster and its associated morbidity are discussed, including zoster vaccine and the use of antivirals.

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Section: Incidence Among Immunosuppressedmentioning

confidence: 99%

The Epidemiology and Prevention of Herpes Zoster

2012

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“…8 Moreover Dreiher et al in 2011, analyzed the risk of HZ in a group of 22.330 psoriatic patients treated with systemic therapies: among the anti-TNF-α, only the association with infliximab approached statistical significance with the risk of HZ while no cases of HZ were seen among patients treated with adalimumab. 9 A detailed cumulative analysis of studies which reported the occurrence of HZ during anti-TNF-α treatment it is shown in Table 1.…”

Section: Case Reportmentioning

confidence: 99%

“…A detailed cumulative analysis of studies which reported the occurrence of HZ during anti-TNF-α treatment it is shown in Table 1. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17] TNF-α inhibits replication of VZV and VZV antigen expression and it has been shown that blocking of TNF-α by monoclonal antibodies completely inhibits this antiviral activity. …”

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confidence: 99%

“…We report this case to highlight the increased risk of HZ infections in patient on anti-TNF-α therapy and to enrich the literature: there is a very limited number of studies regarding the development of HZ during adalimumab therapy 3,7,13,14 among the case reports and surveys which describe the occurrence of HZ during anti-TNF-α treatment. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17] It is very important to identify early signs and symptoms of HZ in these patients in order to start prompt efficient antiviral therapy to prevent the development of severe complications.The risk of herpes zoster in the anti-TNF-α era: a case report and review of the literature, Di Costanzo et al …”

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confidence: 99%

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The risk of herpes zoster in the anti-TNF-α era: a case report and review of the literature

Costanzo

Ayala²,

Megna³

et al. 2013

J Dermatol Case Rep

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Background: Tumor necrosis factor-α (TNF-α) inhibitors represent efficacious therapeutic agents in many chronic inflammatory diseases such as psoriasis and rheumatoid arthritis. However they have been connected with increased risk of infection and reactivation of a variety of infectious agents, such as viruses. The reactivation of varicella zoster virus infection causes herpes zoster (HZ), a self-limiting, dermatomally localized, vesicular rash that can be accompanied by postherpetic neuralgia and severe neurological complications.Main observations: Limited information has been published regarding HZ during therapy with TNF-α inhibitors especially for the occurrence of HZ during adalimumab treatment. We report the case of a 58-year-old immunocompetent man with a 18-year history of plaque psoriasis who develops ophthalmic HZ during treatment with adalimumab. Conclusion:We report this case to enrich the literature and to highlight the increased risk of HZ infections in patient on anti-TNF-α therapy (incidence of HZ is about 3-fold increased respect to general population). Clinically, these infections often have atypical presentations that may hamper prompt diagnosis. Therefore, it is very important to identify early signs and symptoms of herpes zoster in patients on biologic therapy in order to start prompt efficient antiviral treatment to prevent the development of severe complications. (J Dermatol Case Rep. 2013; 7(1): 1-4) The risk of herpes zoster in the anti-TNF-α era: a case report and review of the literature Luisa Di Costanzo, Fabio Ayala, Matteo Megna, Francesca Gaudiello, Angela Patrì, Nicola Balato Department of Dermatology -University of Naples Federico II, Naples, Italy. IntroductionThe course of chronic inflammatory diseases, such as psoriasis and rheumatoid arthritis, has been greatly modified by the relatively recent introduction of biologic drugs. Biologic agents include tumor necrosis factor alpha (TNF-α) inhibitors, namely adalimumab, infliximab, golimumab (monoclonal antibodies) and etanercept (dimeric fusion protein). Varicella zoster virus (VZV) is an herpes-virus which establishes latency in neural tissue following primary infection. Reactivation of latent VZV from dorsal root ganglia causes herpes zoster (HZ), a neurocutaneous, painful and dermatomally localized vesicular rash disease. We report the case of a 58-year-old man suffering from psoriasis who develops ophthalmic HZ during treatment with adalimumab. Case ReportA 58-year-old immunocompetent man with a 18-year history of plaque psoriasis presented to our outpatient clinic with some confluent hemorrhagic vesicles within an erythematous background localized on the scalp and the right side of the frontal region including the tip of the nose (Fig. 1). These lesions, measuring from 2 to 8 mm in diameter, were characterized by intense itching. In addition they presented a distinctive localization and an unilateral distribution indicating the involvement of the ophthalmic area of the right side of the face. The patient report...

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“…While the risk of potential reactivation of VZV is very low when a patient is taking a biologic drug, 65,66 the risk increases when this patient is also taking oral prednisone for a comorbidity. Reactivation of VZV can lead to a potentially serious neurological complication, 67,68 and VZV vasculopathies in immunocompromised patients have been described in the literature.…”

Section: Reactivation Of Varicella Zostermentioning

confidence: 99%