Anti-TNF-αlpha Agents and Herpes Zoster

Drugs that inhibit tumor necrosis factor-alpha (TNF-αlpha) may be effective therapy for patients with rheumatoid arthritis (RA) who do not experience relief from their condition from conventional disease modifying antirheumatic drugs (DMARDs). Unfortunately, anti-TNF-αlpha agents make patients more vulnerable to bacterial infection. There also is concern that patients may be similarly at risk for viral infection since herpes zoster is one of the most common adverse events reported by patients taking anti-TNF-αlpha agents and retrospective data suggest that herpes zoster occurs more often in patients with than in those without RA. To prospectively evaluate the risk of reactivation of the varicella zoster virus in patients taking varying RA treatments (with different mechanisms of action), researchers from German Rheumatism Research Centre and Charité-University Medicine, both in Berlin, Germany, analyzed data on 5,040 patients.