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Journal article
The Severity of Herpes Zoster in Inflammatory Bowel Disease Patients Treated With Anti-TNF Agents
Inflammatory bowel diseases, v 24(6), pp 1274-1279
01 Jun 2018
PMID: 29522099
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Aim: There is a paucity of data on the clinical course and the factors affecting the clinical course of herpes zoster (HZ) in inflammatory bowel disease (IBD). Our aim was to determine the impact of anti-TNF therapy and other factors on the clinical course of HZ in IBD patients.
Methods: We conducted a retrospective cohort study among a cohort of nation-wide Veterans Affairs patients with IBD who developed incident HZ. The exposed group consisted of eligible study patients who were actively exposed to anti-TNF alone or anti-TNF plus thiopurines at the time of HZ onset. The unexposed group consisted of patients who were only exposed to 5-ASA agents before the onset of HZ without any exposure to anti-TNF medications. The outcome of interest was the development of severe HZ that was defined by including various HZ complications.
Results: A total of 295 patients were identified with an incident HZ flare during follow-up duration, and among them 69 met the definition of having a severe flare. In multivariable logistic regression analysis adjusting for sex, age at HZ flare onset, race, Charlson comorbidity score, and receipt of oral anti-HZ treatment, exposure to anti-TNF agent was not associated with an increased risk of severe HZ flare compared to exposure to mesalamine alone (adjusted relative risk (RR) 1.1, 95% confidence intervals (CI): 0.75-1.55). Among the covariates, receipt of oral anti-HZ treatment (adjusted RR 0.42, 95% CI: 0.29-0.61), advancing age at HZ onset (adjusted RR for each year increase in age 1.02, 95% CI: 1.00-1.04), and African-American race (adjusted RR with whites as reference 1.58, 95% CI: 1.02-2.44) were significantly associated with the risk of having severe HZ flare.
Conclusion: Our study showed that among IBD patients who developed HZ, treatment with anti-TNF agents was not associated with increased risk of developing severe HZ as compared to patients treated with 5-ASA therapy only.
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Details
- Title
- The Severity of Herpes Zoster in Inflammatory Bowel Disease Patients Treated With Anti-TNF Agents
- Creators
- Nabeel Khan - Philadelphia VA Medical CenterChinmay Trivedi - Philadelphia VA Medical CenterYash Shah - Mount Sinai Medical CenterDhruvan Patel - Drexel UniversityJames Lewis - University of PennsylvaniaYu-Xiao Yang - Philadelphia VA Medical Center
- Publication Details
- Inflammatory bowel diseases, v 24(6), pp 1274-1279
- Publisher
- Oxford Univ Press
- Number of pages
- 6
- Grant note
- Pfizer pharmaceuticals; Pfizer
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Gastroenterology and Hepatology
- Web of Science ID
- WOS:000432697200018
- Scopus ID
- 2-s2.0-85047509710
- Other Identifier
- 991019168551504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology