Herpes Zoster Risk May Be Elevated In Psoriasis Patients On Combination Therapy

MedicalResearch.com Interview with:
Arnon D. Cohen, MD, MPH, PhD
Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv
Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

MedicalResearch: What is the background for this study?

Dr. Cohen: Herpes zoster (HZ), or shingles, is the consequence of reactivation of endogenous latent varicella zoster virus infection within the sensory ganglia. HZ is a major public health concern. It is a significant contributor of morbidity, disability, and chronic pain in the form of post-herpetic neuralgia.

The use of TNF-α inhibitors in rheumatoid arthritis and similar diseases and the risk for Herpes zoster has been assessed in several studies. However, the use of TNF-α inhibitors treatment in patients with psoriasis and the risk for Herpes zoster has been investigated to a lesser extent. Limited data is available regarding the association between the use of systemic medications or phototherapy and HZ in patients with psoriasis.

MedicalResearch: What are the main findings?

Dr. Cohen: Among 95,941 Clalit Health Services patients with psoriasis, 4,636 episodes of Herpes zoster were observed in a follow-up period of 11 years and 7 months. Monotherapy with biologic or systemic treatment was not associated with an increased risk for Herpes zoster. In a multivariate analysis, the use of combination treatment with biologic medications and methotrexate was significantly associated with an increased incidence of Herpes zoster.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Cohen: The present study demonstrates an increased risk for Herpes zoster among patients with psoriasis treated with combination treatment with biologic medications and methotrexate. Physicians may need to consider offering Herpes zoster preventive vaccine to patients receiving such treatments, particularly in the setting of additional risk factors for HZ.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Cohen: Future studies should focus on the use of Herpes zoster vaccine in patients with psoriasis who are treated with systemic or biologic medications.


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MedicalResearch.com Interview with: Arnon D. Cohen, MD, MPH, PhD (2015). Herpes Zoster Risk May Be Elevated In Psoriasis Patients On Combination Therapy 

Last Updated on April 11, 2015 by Marie Benz MD FAAD