Shingles 'risk' of arthritis drug

From BBC News:

Some popular treatments for rheumatoid arthritis could increase the risk of the painful condition shingles, a German study suggests.

Anti-TNF (anti-tumour necrosis factor alpha) therapy drugs can slow the progress of disease and help to reduce some of the worst symptoms.

But some of them may make patients more vulnerable to shingles, a skin disease which produces sore, itchy blisters.

Writing in JAMA, the authors advised patients on such drugs be monitored.

The team at the Rheumatism Research Centre in Berlin analysed data from more than 5,000 patients on different forms of treatment.

There were 86 outbreaks of shingles - triggered by the virus Herpes zoster - among 82 patients. Thirty-nine of these coincided with treatment with the anti-TNF drugs adalimumab and infliximab.

Etanercept, a protein therapy, and conventional disease-modifying anti-rheumatic drugs were associated with 23 and 24 cases respectively.

After adjusting for the age of the patient, the severity of their illness and their use of steroid hormone therapies, researchers found that the risk for patients on the anti-TNF programme almost doubled.

Although this was beneath the threshold of clinical significance, which would be an increase of more than double, the researchers, led by Dr Anja Strangfeld, said their findings suggested doctors should be on the look out for shingles in the patients they treat with these drugs.

Shingles is the reactivation of the virus infection that causes chickenpox. After a person has had the infection, usually as a child, the virus remains in their body and can return, usually after the age of 50.

A weakened immune system is thought to be one of the triggers, and it is suggested that this may be why anti-TNF drugs could have this effect.

Posted: 2/18/2009 10:15:00 AM

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