Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study

Abstract The incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zost...

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Autores principales:	Sze-Wen Ting, Sze-Ya Ting, Yu-Sheng Lin, Ming-Shyan Lin, George Kuo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2cf49c3f558e48b2a34124e96af85b9d
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spelling	oai:doaj.org-article:2cf49c3f558e48b2a34124e96af85b9d2021-12-02T17:50:49ZRisk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study10.1038/s41598-021-91356-32045-2322https://doaj.org/article/2cf49c3f558e48b2a34124e96af85b9d2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91356-3https://doaj.org/toc/2045-2322Abstract The incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.Sze-Wen TingSze-Ya TingYu-Sheng LinMing-Shyan LinGeorge KuoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sze-Wen Ting Sze-Ya Ting Yu-Sheng Lin Ming-Shyan Lin George Kuo Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
description	Abstract The incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.
format	article
author	Sze-Wen Ting Sze-Ya Ting Yu-Sheng Lin Ming-Shyan Lin George Kuo
author_facet	Sze-Wen Ting Sze-Ya Ting Yu-Sheng Lin Ming-Shyan Lin George Kuo
author_sort	Sze-Wen Ting
title	Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
title_short	Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
title_full	Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
title_fullStr	Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
title_full_unstemmed	Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
title_sort	risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2cf49c3f558e48b2a34124e96af85b9d
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Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study

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