Risk of Shingles May Increase in Rheumatoid Arthritis Patients Using Certain TNF Blockers

You've likely heard that the risk of bacterial infection is increased in rheumatoid arthritis patients treated with drugs known as TNF-alpha blockers. But, until now, little has been reported about the risk of viral infections. According to study results published in the February 18, 2009 issue of the Journal of the American Medical Association (JAMA), researchers concluded that treatment with monoclonal TNF-alpha blockers may be associated with an increased risk of herpes zoster -- the virus that causes shingles.

Researchers set out to study whether TNF-alpha blockers together as a class, or separately as either monoclonal anti-TNF antibodies (Humira or Remicade) or the fusion protein (Enbrel), were associated with higher rates of herpes zoster in rheumatoid arthritis patients. Of 5,040 patients who received TNF blockers or conventional DMARDs, there were 86 episodes of herpes zoster in 82 patients. Thirty-nine of the episodes were linked to treatment with the monoclonal TNF blockers, 23 to Enbrel, and 24 to conventional DMARDs. Researchers concluded that there was no significant association between herpes zoster and treatment with Enbrel or TNF blockers as a drug class. They did recommend careful monitoring of patients using mononclonal TNF blockers for early signs of herpes zoster.

I can't say I was thrilled to see this report, since I have been on Remicade since 2001, but I'm not going into a panic over it either. I will watch for early signs, as they recommended, for herpes zoster -- or any other infection for that matter.

Related Resources:

• What Is a Monoclonal Antibody?
• TNF-alpha Blockers - What You Need to Know
• Test Your Knowledge - TNF Blockers
• Enbrel, Remicade, and Humira - Similarities and Differences
• Herpes Zoster - Risk Increases With Rheumatoid Arthritis and DMARD Use

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