Higher Risk for Herpes Zoster Complications With IBD

TOPLINE:

Patients with inflammatory bowel disease (IBD) face a higher risk for complications of herpes zoster than those without IBD, with older age, higher comorbidity scores, and management with anti–tumor necrosis factor (anti-TNF) therapy or prednisone being significant risk factors for complications.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using the Optum Research Database to investigate the risk for complications of herpes zoster, also known as shingles, in patients with IBD.
• They included 4756 patients (mean age, 54.53 years; 59% women) with IBD who also had a diagnosis of herpes zoster and matched them to the same number of control participants without IBD. The vast majority of patients had not received vaccination against herpes zoster (94.3% in the IBD cohort; 93.5% in the non-IBD group).
• Complications of herpes zoster that occurred up to 90 days after the diagnosis of the condition were identified using diagnosis codes.
• The primary outcome was any complication from herpes zoster, such as post-herpetic neuralgia, multi-dermatomal involvement, hospitalization, ophthalmic involvement, neurologic complications, zoster with other complications, or multiorgan involvement.

TAKEAWAY:

• Patients with IBD were 28% more likely to have complications of herpes zoster than those without IBD (P P
• The risk for complications of herpes zoster was the highest in the subgroup of patients older than 65 years (odds ratio [OR], 3.82; P P 4 (OR, 1.78; P = .0001).
• In terms of IBD treatment, the risk for complications was significantly higher in patients on anti-TNF therapy (OR, 1.64; P P = .0304).
• Post-herpetic neuralgia was the most frequent complication in the IBD cohort, occurring in 6% of those patients and accounting for 36% of all complications.

IN PRACTICE:

“This study serves as a call to action for gastroenterologists in addressing the elevated risk of HZ [herpes zoster] complications in patients with IBD. By leveraging the risk factors and medication associations identified in our study, and the proven benefits of vaccination in other studies, gastroenterologists can optimize patient care and contribute to reducing the burden of HZ-related complications,” the authors wrote.

SOURCE:

This study, led by Freddy Caldera, DO, PhD, University of Wisconsin–Madison, was published online in Clinical Gastroenterology and Hepatology.

LIMITATIONS:

The retrospective nature of this study may have limited the ability to establish causality between IBD and complications of herpes zoster. The evaluation of the correlation between Janus kinase inhibitors and non-TNF biologics and complications of herpes zoster was limited by the small number of patients receiving these medications. This study also lacked data on measures of disease activity.

DISCLOSURES:

This study received funding from Optum. Some authors disclosed receiving research support or serving as consultants for various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.