Risk for herpes zoster complications appears higher with IBD
A retrospective cohort study found that herpes zoster complications occurred in 15.52% of patients with inflammatory bowel disease (IBD) who got the virus versus 12.51% of those without IBD, a statistically significant difference.
Patients with inflammatory bowel disease (IBD) may be at higher risk for complications from herpes zoster, a recent study found.
U.S. researchers performed a retrospective cohort study in which data from patients with IBD were matched 1:1 with data from non-IBD controls according to age, sex, and index year, defined as a herpes zoster diagnosis. Patients were considered to have IBD if they had at least two IBD-related inpatient or outpatient visits between 2007 and 2022 and had at least one outpatient pharmacy claim for aminosalicylates, thiopurine, methotrexate, anti-tumor necrosis factor (TNF) agents (infliximab, adalimumab, certolizumab, or golimumab), vedolizumab, tofacitinib, or ustekinumab before herpes zoster diagnosis.
Complications of herpes zoster up to 90 days after the index date were compared among those with IBD and controls. The goals of the study were determining whether patients with IBD were at higher risk for herpes zoster complications and whether risk was increased with certain immunosuppressive therapies. The study was funded by a grant from the company that supplied the patient data. The results were published by Clinical Gastroenterology and Hepatology on Oct. 24.
Overall, 4,756 patients with IBD were included in the study and matched with controls. Herpes zoster complications were more common among patients with IBD than controls (15.52% vs. 12.51% [P<0.0001]; odds ratio, 1.28 [95% CI, 1.14 to 1.42]). Patients with IBD who developed herpes zoster complications were older (60.9 vs. 53.4 years; P<0.0001) and had higher Charlson comorbidity scores (1.86 vs. 1.18; P<0.0001) than IBD patients who did not. In a logistic regression analysis, patients with IBD who had a higher comorbidity score, who were older than 50 years of age, and who were taking anti-TNF drugs or corticosteroids were all at higher risk.
The authors noted that they couldn't assess whether non-TNF biologics and Janus kinase inhibitors were associated with herpes zoster complications, that there were limited data on disease activity measures, and that recombinant herpes zoster vaccination rates were low, among other limitations. They called for efforts to address the higher risk of herpes zoster complications among patients with IBD to optimize care and help reduce the resulting clinical burden.