Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan.
M. Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan.
Int J Environ Res Public Health. 2023 Jan 24;20(3):2123. doi: 10.3390/ijerph20032123.
Rheumatoid arthritis (RA) was associated with the risk of incident herpes zoster (HZ), which might be influenced by medication use by RA patients. We aimed to investigate the association of RA with the risk of incident HZ and how the HZ risk effected by RA medications in CIC RA patients. We conducted an observational study including population-based representative insurance claims data of 19,673 patients with RA and 39,346 matched patients without RA during 1997-2010 from the Taiwan National Health Insurance Research Database; we identified 1651 patients with catastrophic illness-certified (CIC) RA and 11,557 matched patients with non-CIC RA. Exploratory analyses assessed the association between RA/CIC RA and risk of incident HZ and its complications. The association of prescribed medications with HZ risk in CIC RA patients was also estimated. The incidence rates of HZ were higher in CIC RA patients and non-CIC RA than in the matched people without RA (21.95 and 14.03 vs. 7.36 events per 1000 person-years, respectively). The adjusted incidence rate ratio (95% confidence interval (CI)) for HZ was 1.74 (1.65-1.84) in RA patients vs. matched non-RA and 1.65 (1.44-1.89) in CIC RA patients vs. non-CIC RA. For HZ complications, RA had a 2.85-fold higher risk than non-RA, and CIC RA had a 1.78-fold higher risk than non-CIC RA. Moreover, in CIC RA patients, prednisolone use was associated with incident HZ risk compared with prednisolone nonuse (adjusted odds ratio 1.48, 1.08-2.03); prolonged prednisolone use (approximately 5 years) increased the risk (adjusted odds ratio 2.16, 1.46-3.19). Our results suggested that RA was positively associated with HZ risk, particularly in RA patients with prednisolone use.
类风湿关节炎（RA）与带状疱疹（HZ）发病风险相关，而 RA 患者的药物使用可能会影响 HZ 发病风险。本研究旨在探讨 RA 与 HZ 发病风险的关系，以及 RA 药物如何影响 CIC-RA 患者的 HZ 发病风险。我们进行了一项观察性研究，纳入了 1997 年至 2010 年来自台湾全民健康保险研究数据库的 19673 名 RA 患者和 39346 名匹配的无 RA 患者的基于人群的代表性保险索赔数据；我们确定了 1651 名患有灾难性疾病认证（CIC）RA 的患者和 11557 名患有非 CIC-RA 的匹配患者。探索性分析评估了 RA/CIC-RA 与 HZ 发病风险及其并发症的关系。还估计了 CIC-RA 患者中规定药物与 HZ 发病风险的关系。CIC-RA 患者和非 CIC-RA 患者的 HZ 发生率均高于无 RA 的匹配人群（分别为 21.95 和 14.03 例/1000 人年）。与匹配的非 RA 患者相比，RA 患者的 HZ 调整发病率比（95%置信区间（CI））为 1.74（1.65-1.84），CIC-RA 患者为 1.65（1.44-1.89）。对于 HZ 并发症，RA 的风险是无 RA 的 2.85 倍，CIC-RA 的风险是无 CIC-RA 的 1.78 倍。此外，在 CIC-RA 患者中，与不使用泼尼松龙相比，使用泼尼松龙与 HZ 发病风险相关（调整优势比 1.48，1.08-2.03）；泼尼松龙使用时间延长（约 5 年）会增加风险（调整优势比 2.16，1.46-3.19）。我们的结果表明，RA 与 HZ 发病风险呈正相关，特别是在使用泼尼松龙的 RA 患者中。
