Rheumatism drugs may increase shingles risk

By Liam Davenport

Patients with inflammatory rheumatic disease treated with one of the most effective medicines for their disease face a substantially increased risk for developing shingles, warn European researchers who suggest vaccination may be an option.

Medicines called anti-tumor necrosis factor (TNF) drugs are highly effective against inflammatory rheumatic diseases, but previous research has shown that they may increase the risk of infections.

Investigating whether the risk of shingles, which is a painful, blistering skin rash caused by the varicella-zoster virus, is increased by anti-TNF drugs, Helen Che, from Lapeyronie Hospital in France, and colleagues carried out a review of research into the treatment of inflammatory rheumatic diseases.

In total, 50 studies, published between 2006 and 2010, were included in the analysis.

The findings showed that patients given anti-TNF medications for rheumatic diseases had a 75% increased risk for developing shingles compared with those treated with other drugs.

The actual rate of shingles ranged from almost 5% in German patients treated with anti-TNF medications to over 20% in US patients.

Speaking at the Annual Congress of the European League Against Rheumatism, held in Berlin, Germany, Dr Che commented: "This systematic review and meta-analysis demonstrated that careful monitoring of patients treated with anti-TNFs is required for early signs and symptoms of herpes zoster and raises the issues as to when vaccination against the virus should occur."

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