(Reuters Health)—The live herpes zoster vaccine does not provide reliable long-term protection in rheumatoid arthritis (RA) patients taking tofacitinib, a recent study suggests. Current ACR guidelines conditionally recommend that patients with RA who are 50 years and older be vaccinated against herpes zoster prior to starting therapy with the Janus kinase (JAK) inhibitor tofacitinib or…
Zoster Reactivation Risk in Patients Treated with Cyclophosphamide
Varicella-zoster-virus (VZV) reactivation, which can cause patients to develop herpes zoster (i.e., shingles), occurs more frequently in patients with systemic vasculitis and systemic lupus erythematosus (SLE) who have received intravenous cyclophosphamide than in otherwise healthy adults, according to a retrospective study published in The Journal of Rheumatology by researchers in France.1 The study also shows…
Herpes Zoster & Tofacitinib
Shingles, also known as herpes zoster (HZ), is a common and sometimes debilitating disease that disproportionately affects elderly individuals and those who are immunocompromised. Patients with rheumatoid arthritis (RA) have a 1.5–2-fold higher risk of developing HZ compared with healthy adults. Treatment with some disease-modifying anti-rheumatic drugs (DMARDs) has been shown to increase this risk….
Herpes Zoster & the Risk of Stroke in Patients with Autoimmune Diseases
Herpes zoster (HZ) infection, also known as shingles, is caused by reactivation of latent varicella-zoster virus infection generally acquired decades earlier. This study was designed to test the hypothesis that the incidence of stroke immediately following HZ infection is increased in patients with autoimmune diseases compared with the incidence of stroke at later time points. Results: In patients with autoimmune diseases, incident HZ was associated with as much as a twofold increased risk of stroke. Prompt antiviral therapy was associated with lower incidence of subsequent stroke…
Shingles Vaccination Not at Goal Levels for U.S. Seniors
(Reuters Health)—Just one in five people over age 60 in the U.S. have been vaccinated against a painful eruption of herpes zoster (shingles), despite recommendations that all of them should get the shot. It’s estimated that among people over age 50, one in three will eventually develop shingles. After age 80, half of adults have…
Tips on Vaccinating Patients with Rheumatic Diseases
CHICAGO—In October of last year, a 52-year-old woman came to see Kevin Winthrop, MD, MPH, associate professor in infectious diseases, public health and preventive medicine at the Oregon Health & Sciences University. She had rheumatoid arthritis and was taking methotrexate and prednisone. She had had little change in her RA disease severity and was considering…