Treatment with anti-TNFs can increase the risk of Herpes Zoster by up to 75 percent

Patients with inflammatory rheumatic diseases treated with anti-TNFs such as Remicade have a 75% greater risk of developing Herpes Zoster, or shingles, than patients treated with traditional disease modifying anti-rheumatic drugs (DMARDs), according to a meta-analysis presented at the Annual Congress of the European League Against Rheumatism. The study is based on a literature search in Medline, Embase, the Cochrane library and abstracts from ACR and EULAR congresses from 2006 to 2010. The meta-analysis included a total follow up of 124,966 patient years (PY) (74,198 PY in the biologics group and 50,768 PY in the DMARD group) across five registries. This systematic review and meta-analysis demonstrates that careful monitoring of patients treated with anti-TNFs is required for early signs and symptoms of herpes zoster and raises the issue as to when vaccination against the virus should occur, according to Helene Che, from Lapeyronie Hospital, France and lead author of the study.