2011年至2015年生物制剂时代类风湿关节炎患者的带状疱疹风险及其与甲氨蝶呤、生物制剂和皮质类固醇的关联。

Risk of herpes zoster in patients with rheumatoid arthritis in the biologics era from 2011 to 2015 and its association with methotrexate, biologics, and corticosteroids.

作者信息

Yamaguchi Rei, Tanaka Eiichi, Nakajima Ayako, Inoue Eisuke, Abe Mai, Sugano Eri, Sugitani Naohiro, Saka Kumiko, Ochiai Moeko, Higuchi Yoko, Sugimoto Naoki, Ikari Katsunori, Yamanaka Hisashi, Harigai Masayoshi

机构信息

Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.

出版信息

Mod Rheumatol. 2022 Apr 18;32(3):522-527. doi: 10.1093/mr/roab026.

DOI:10.1093/mr/roab026

PMID:34897494

Abstract

OBJECTIVES

To elucidate the incidence and risk factors of herpes zoster (HZ) in patients with rheumatoid arthritis (RA) in the biologics era.

METHODS

We determined the rate of HZ occurrence among the RA patients that participated in the Institute of Rheumatology, Rheumatoid Arthritis surveys from 2011 to 2015, by assessing medical records. The standardised incidence rate per 1000 patient-years with a 95% confidence interval (CI) was calculated, and risk factors for HZ were analysed using a time-dependent Cox regression analysis.

RESULTS

Among 7815 patients (female, 84.7%) contributing to 25,863 patient-years of observation, 340 HZ events in 309 patients were confirmed. The standardised incidence rate (95% CI) per 1000 patient-years was 8.5 (6.9-10.5) in total, 6.0 (3.7-9.2) in men, and 11.0 (8.7-13.7) in women. Risk factors for HZ were age per 10 years (hazard ratio 1.14, 95% CI 1.03-1.26, p < .05), Japanese version of the Health Assessment Questionnaire (J-HAQ) score of 0.5-1.5 (versus J-HAQ = 0; 1.51, 1.09-2.10, p < .05), methotrexate use (1.58, 1.06-2.36, p < .05), and biologic use (1.88, 1.44-2.47, p < .01).

CONCLUSIONS

In the era when biologics were frequently used and corticosteroid use and doses were decreasing, methotrexate and biologics increased the risk for HZ.

摘要

目的

阐明生物制剂时代类风湿关节炎（RA）患者带状疱疹（HZ）的发病率及危险因素。

方法

通过评估病历，我们确定了2011年至2015年参与风湿病研究所类风湿关节炎调查的RA患者中HZ的发生率。计算了每1000患者年的标准化发病率及95%置信区间（CI），并使用时间依赖性Cox回归分析来分析HZ的危险因素。

结果

在7815例患者（女性占84.7%）中，观察时间达25863患者年，共确诊309例患者发生340次HZ事件。每1000患者年的标准化发病率（95%CI）总体为8.5（6.9 - 10.5），男性为6.0（3.7 - 9.2），女性为11.0（8.7 - 13.7）。HZ的危险因素包括每增加10岁（风险比1.14，95%CI 1.03 - 1.26，P < 0.05）、日本版健康评估问卷（J - HAQ）评分为0.5 - 1.5（与J - HAQ = 0相比；1.51，1.09 - 2.10，P < 0.05）、使用甲氨蝶呤（1.58，1.06 - 2.36，P < 0.05）以及使用生物制剂（1.88，1.44 - 2.47，P < 0.01）。