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Increased risk of Herpes zoster in IBD

Published ahead of print in the Alimentary Pharmacology & Therapeutics, a study investigates the risk of Herpes zoster in patients with IBD.

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Patients with inflammatory bowel disease (IBD) on certain immunosuppressants have increased herpes zoster risk.

Dr Long and colleagues determined the risk of herpes zoster in IBD and how antitumor necrosis factor-alpha (anti-TNF) agents affect this risk.

The researchers performed a retrospective cohort and nested case–control study using administrative data from IMS LifeLink® Information Assets-Health Plan Claims Database.

In the cohort, the research team identified IBD patients under the age of 64 by diagnosis codes.

The team matched the each of the patients to 4 individuals without IBD.

Herpes zoster risk was evaluated by incidence rate ratio, and adjusted Cox proportional hazards models.
Herpes zoster risk was highest with combination anti-TNF and thiopurine therapy
Alimentary Pharmacology & Therapeutics

In the nested case–control analysis, 2659 IBD patients with herpes zoster were each matched to e IBD patients without herpes zoster.

The research team determined associations between medications and herpes zoster using conditional logistic regression.

The cohort included 50,932 patients with Crohn's disease, 56,403 patients with ulcerative colitis, and 1269 with unspecified IBD, matched to 434,416 individuals without IBD.

The team found that IBD patients had a higher risk of herpes zoster than non-IBD.

In the nested case–control multivariate-adjusted analyses, anti-TNF medications, corticosteroids, and thiopurines were independently associated with herpes zoster.

The team found that risk of herpes zoster was highest with combination anti-TNF and thiopurine therapy.

Dr Long's team concludes, "Patients with inflammatory bowel disease are at increased risk for herpes zoster."

"Use of thiopurines, anti-TNF agents, combination therapy and corticosteroids increases herpes zoster risk."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12182
21 December 2012

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