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Ishihara R, Watanabe R, Shiomi M, Katsushima M, Fukumoto K, Yamada S, Okano T, Hashimoto M. Exploring the Link between Varicella-Zoster Virus, Autoimmune Diseases, and the Role of Recombinant Zoster Vaccine. Biomolecules 2024; 14:739. [PMID: 39062454 PMCID: PMC11274381 DOI: 10.3390/biom14070739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
The varicella-zoster virus (VZV) is a human neurotropic herpes virus responsible for varicella and herpes zoster (HZ). Following primary infection in childhood, VZV manifests as varicella (chickenpox) and enters a period of latency within the dorsal root ganglion. A compromised cellular immune response due to aging or immunosuppression triggers viral reactivation and the development of HZ (shingles). Patients with autoimmune diseases have a higher risk of developing HZ owing to the immunodeficiency associated with the disease itself and/or the use of immunosuppressive agents. The introduction of new immunosuppressive agents with unique mechanisms has expanded the treatment options for autoimmune diseases but has also increased the risk of HZ. Specifically, Janus kinase (JAK) inhibitors and anifrolumab have raised concerns regarding HZ. Despite treatment advances, a substantial number of patients suffer from complications such as postherpetic neuralgia for prolonged periods. The adjuvanted recombinant zoster vaccine (RZV) is considered safe and effective even in immunocompromised patients. The widespread adoption of RZV may reduce the health and socioeconomic burdens of HZ patients. This review covers the link between VZV and autoimmune diseases, assesses the risk of HZ associated with immunosuppressant use, and discusses the benefits and risks of using RZV in patients with autoimmune diseases.
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Affiliation(s)
- Ryuhei Ishihara
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Mayu Shiomi
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Masao Katsushima
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Kazuo Fukumoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Shinsuke Yamada
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tadashi Okano
- Center for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
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Domínguez-Casas LC, Lasa-Teja C, Ferraz-Amaro I, Castañeda S, Blanco R. Increased Risk of Herpes Zoster in Rheumatoid Arthritis Not Only Due to JAK Inhibitors-Study of 392 Patients from Single University Center. J Clin Med 2024; 13:3121. [PMID: 38892832 PMCID: PMC11172981 DOI: 10.3390/jcm13113121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/08/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Patients with rheumatoid arthritis (RA) have an increased risk of infection. Their risk of presenting herpes zoster (HZ) is 1.5-2 times higher than immunocompetent individuals and disseminated presentation is more frequent. Our aim was to analyze the prevalence and general features of HZ in RA patients. Methods: This was a prospective study of 392 RA patients included in the vaccination program of our hospital between 2011 and 2016, and follow-up continued until December 2020. A diagnosis of HZ was made according to clinical manifestations: skin rash, blisters, paresthesia, and local pain in one or more dermatomes. Results: We studied 392 participants (309 women/83 men), mean age 59 ± 13 years. Every patient was followed-up over a mean period of 137 ± 110 months (range: 42 months-42 years). HZ infection was observed in 30 of 392 (25 women/5 men) patients, age (mean ± SD) 64.7 ± 11.8 years. Prevalence was 7.65% in this period and the incidence rate was 13.22/1000 patients/year. Three patients had facial involvement, one had optic involvement, and one patient presented disseminated HZ. Seven patients presented post herpetic neuralgia treated with gabapentinoids. The main features of RA of these 30 patients were: positive RF (n = 17; 56.6%), positive anti-CCP (n = 13; 43.3%), and erosive disease (n = 10; 33.3%). At HZ infection, the treatments were glucocorticoids (n = 19; 63.3%), conventional DMARDs (n = 15; 50%), biological DMARDs (n = 15; 50%), tofacitinib (n = 2; 6.6%), and upadacitinib (n = 1; 3.3%). Conclusions: HZ is a relatively frequent viral complication in RA patients. In our series, one patient presented disseminated HZ and nearly 25% of patients had post-herpetic neuralgia. Including a HZ vaccine in our vaccination program for RA patients may be beneficial.
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Affiliation(s)
| | - Carmen Lasa-Teja
- Rheumatology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Iván Ferraz-Amaro
- Rheumatology, Hospital Universitario de Canarias, 38320 Tenerife, Spain;
| | - Santos Castañeda
- Rheumatology, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain;
| | - Ricardo Blanco
- Rheumatology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
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Pier M, Wolbink G, Boekel L. Time to talk to adults with rheumatic diseases about herpes zoster vaccination. THE LANCET. RHEUMATOLOGY 2024; 6:e247-e251. [PMID: 38373432 DOI: 10.1016/s2665-9913(24)00019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
The 2019 European Alliance of Associations for Rheumatology (EULAR) recommendations on herpes zoster vaccination for adult patients with rheumatic immune-mediated inflammatory diseases stated that these patients are at increased risk of herpes zoster compared with the general population. However, these recommendations lack clarity and specificity and are cautiously phrased, which might cause physicians to underestimate the importance of herpes zoster vaccination for these patients, potentially resulting in suboptimal protection. Since the formulation of the 2019 EULAR guidelines, new data on herpes zoster in patients with immune-mediated inflammatory diseases have been published. Moreover, a recombinant herpes zoster vaccine (Shingrix) has become available that can be given to these patients in a more accessible manner than the original live-attenuated vaccine (Zostavax). Here, we evaluate existing evidence on risk factors for herpes zoster and the safety and efficacy of the recombinant vaccine in patients with rheumatic immune-mediated inflammatory diseases and discuss the necessity of herpes zoster vaccination for these patients.
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Affiliation(s)
- Mischa Pier
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
| | - Gertjan Wolbink
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands; Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Laura Boekel
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands.
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Dlamini ST, Htet KM, Theint ECC, Mayadilanuari AM, Li WM, Tung YC, Tu HP. Herpes Zoster Risk in Patients with Rheumatoid Arthritis and Its Association with Medications Used. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2123. [PMID: 36767490 PMCID: PMC9915285 DOI: 10.3390/ijerph20032123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Rheumatoid arthritis (RA) was associated with the risk of incident herpes zoster (HZ), which might be influenced by medication use by RA patients. We aimed to investigate the association of RA with the risk of incident HZ and how the HZ risk effected by RA medications in CIC RA patients. We conducted an observational study including population-based representative insurance claims data of 19,673 patients with RA and 39,346 matched patients without RA during 1997-2010 from the Taiwan National Health Insurance Research Database; we identified 1651 patients with catastrophic illness-certified (CIC) RA and 11,557 matched patients with non-CIC RA. Exploratory analyses assessed the association between RA/CIC RA and risk of incident HZ and its complications. The association of prescribed medications with HZ risk in CIC RA patients was also estimated. The incidence rates of HZ were higher in CIC RA patients and non-CIC RA than in the matched people without RA (21.95 and 14.03 vs. 7.36 events per 1000 person-years, respectively). The adjusted incidence rate ratio (95% confidence interval (CI)) for HZ was 1.74 (1.65-1.84) in RA patients vs. matched non-RA and 1.65 (1.44-1.89) in CIC RA patients vs. non-CIC RA. For HZ complications, RA had a 2.85-fold higher risk than non-RA, and CIC RA had a 1.78-fold higher risk than non-CIC RA. Moreover, in CIC RA patients, prednisolone use was associated with incident HZ risk compared with prednisolone nonuse (adjusted odds ratio 1.48, 1.08-2.03); prolonged prednisolone use (approximately 5 years) increased the risk (adjusted odds ratio 2.16, 1.46-3.19). Our results suggested that RA was positively associated with HZ risk, particularly in RA patients with prednisolone use.
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Affiliation(s)
| | - Kyaw Moe Htet
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Ei Chue Chue Theint
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | | | - Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Urology, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 90054, Taiwan
| | - Yi-Ching Tung
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
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Ishiguro N, Tanaka Y, Matsubara T, Atsumi T, Amano K, Sugiyama E, Yamaoka K, Winthrop K, Kivitz A, Burmester GR, Gottenberg JE, Genovese MC, Matzkies F, Guo Y, Jiang D, Bartok B, Pechonkina A, Kondo A, Besuyen R, Takeuchi T. Integrated safety analysis of filgotinib treatment for rheumatoid arthritis in patients from Japan over a median of 1.5 years. Mod Rheumatol 2023; 33:64-72. [PMID: 35365828 DOI: 10.1093/mr/roac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Characterize safety of the Janus kinase-1 preferential inhibitor filgotinib (FIL) in Japanese patients with moderately to severely active rheumatoid arthritis (RA). METHODS Data from three Phase 3 trials (NCT02889796, NCT02873936, and NCT02886728) and a long-term extension (NCT03025308) through September 2019 were integrated; patients received ≥1 dose of FIL 200 (FIL200) or 100 mg (FIL100) daily, or placebo (PBO). We calculated exposure-adjusted incidence rates (EAIRs) per 100 patient-years FIL exposure (100PYE) for treatment-emergent adverse events (TEAEs) and adverse events of special interest. RESULTS Among 3691 total patients and 6080.7 PYE, 229 Japanese patients received FIL for 311.4 PYE (median 1.5, maximum 2.5 years). During the 12-week PBO-controlled period, serious TEAEs and TEAEs leading to study drug disruption were comparable between FIL and PBO. Serious infection rates were 1.9%, 0%, and 2% for FIL200, FIL100, and PBO during the PBO-controlled period; long-term FIL200 and FIL100 EAIRs were 3.8 and 2.1/100PYE. No herpes zoster (HZ) or major adverse cardiovascular events (MACEs) occurred during the PBO-controlled period; long-term FIL200 and FIL100 EAIRs were 3.0 and 2.1/100PYE (HZ) and 0.6 and 0/100PYE (MACE). CONCLUSION Long-term FIL treatment (median 1.5, maximum 2.5 years exposure) was well tolerated at 100- and 200-mg doses in Japanese patients with RA.
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Affiliation(s)
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tsukasa Matsubara
- Department of Orthopedics, Matsubara Mayflower Hospital, Katō, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical University, Kawagoe, Japan
| | - Eiji Sugiyama
- Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kevin Winthrop
- Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Alan Kivitz
- Altoona Center for Clinical Research, Duncansville, PA, USA
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité University Hospital Berlin, Berlin, Germany
| | | | | | | | - Ying Guo
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | | | | | | | | | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Kobayashi T, Ito S, Murasawa A, Ishikawa H, Tabeta K. Periodontitis severity affects the clinical response to biological disease-modifying antirheumatic drugs in rheumatoid arthritis: A 1-year follow-up study. Mod Rheumatol 2023; 33:81-87. [PMID: 34865087 DOI: 10.1093/mr/roab121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/25/2021] [Accepted: 11/28/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess whether periodontitis severity affects the clinical response to biological disease-modifying antirheumatic drugs (bDMARDs) for 1 year in rheumatoid arthritis (RA) patients. METHODS Data were collected from 50 RA patients who had received corticosteroids, conventional synthetic DMARDs, or non-steroidal anti-inflammatory drugs before (baseline) and after 1 year of bDMARD therapy in a retrospective study. Rheumatologic conditions were compared between the two periodontitis severity groups according to the periodontal inflamed surface area (PISA) or Centers for Disease Control and Prevention (CDC)/American Academy of Periodontology (AAP) case definitions. RESULTS Twenty-eight patients with no or mild periodontitis showed significantly greater decreases in changes in Clinical Disease Activity Index (CDAI) and tender and swollen joint count in comparison to 22 patients with moderate and severe periodontitis (p = .02, p = .01, and p = .03). Both bivariate and multivariate analyses revealed a significantly positive association between the baseline CDC/AAP definitions and CDAI changes (p = .005 and p = .0038). However, rheumatologic conditions were comparable between 25 patients each in the low and high PISA groups. CONCLUSIONS Baseline periodontitis severity according to the CDC/AAP definitions is associated with the clinical response to bDMARDs for 1 year in RA patients.
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Affiliation(s)
- Tetsuo Kobayashi
- General Dentistry and Clinical Education Unit, Faculty of Dentistry & Medical and Dental Hospital, Niigata University, Niigata, Japan.,Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoshi Ito
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Japan
| | - Akira Murasawa
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Japan
| | - Hajime Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, Shibata, Japan
| | - Koichi Tabeta
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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de Queiroz MJ, de Castro CT, Albuquerque FC, Brandão CC, Gerlack LF, Pereira DCR, Barros SC, Andrade WW, Bastos EDA, Azevedo JDNB, Carreiro R, Barreto ML, Santos DB. Safety of biological therapy in patients with rheumatoid arthritis in administrative health databases: A systematic review and meta-analysis. Front Pharmacol 2022; 13:928471. [PMID: 36034855 PMCID: PMC9407686 DOI: 10.3389/fphar.2022.928471] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that affects the synovial fluid of joints, tendons, and some extra-articular sites. Biologic agents have been highly effective and are comparable in reducing RA symptoms, slowing disease progression, and improving physical function; however, concerns have been raised about the risks of several potential adverse effects. Thus, this study aimed to assess the safety of biological therapy in patients with rheumatoid arthritis in observational studies using administrative health databases. Methods: PubMed, Embase, Lilacs, Ovid, Scopus, and Web of Science were searched from inception to 21 October 2021. The analysis was divided into five groups: tumor necrosis factor inhibitors (TNFi) versus non-TNFi; TNFi versus csDMARDs; bDMARDs versus csDMARDs; abatacept versus bDMARDs; and TNFi versus Janus kinase inhibitors (JAKi). The adverse events were cancer, cardiovascular events, infection, herpes zoster, tuberculosis, and death. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. A random-effects model estimated risk ratios with 95% confidence intervals. Results: Thirty-one studies were eligible for inclusion in the present systematic review, published from 2014 to 2021. A total of 1,039,398 RA patients were assessed. The 31 studies evaluated eleven different biological drugs. No significant differences were found regarding safety between TNFi versus non-TNFi (RR 1.08; 95% CI 0.92–1.28; p < 0.01; I2 = 93.0%), TNFi versus csDMARDs (RR 0.91; 95% CI 0.75–1.10; p < 0.01; I2 = 87.0%), bDMARDs versus csDMARDs (RR 0.99; 95% CI 0.82–1.20; p < 0.01; I2 = 93.0%), abatacept versus bDMARDs (RR 0.80; 95% CI 0.54–1.18; p < 0.01; I2 = 90.0%), and TNFi versus JAKi (RR 3.54; 95% CI 0.30–42.09; p = 0.01; I2 = 81.0%). In the subgroup analysis, among studies comparing abatacept to TNFi, a lower risk of cardiovascular events was associated with abatacept (RR 0.37; 95% CI 0.24–0.55). Conclusion: Our results do not suggest an increased risk of adverse events associated with biological therapy in treating RA patients, indicating a lower risk of cardiovascular events with abatacept than TNFi. However, these findings must be interpreted with caution given the limitations of this study and the low/very low certainty of the evidence. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?, identifier [CRD42020190838].
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Affiliation(s)
- Mariana Jorge de Queiroz
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | | | - Celmário Castro Brandão
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Leticia Farias Gerlack
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | - Sandra Castro Barros
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Wenderson Walla Andrade
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | - Ediane de Assis Bastos
- Department of Pharmaceutical Assistance and Strategic Inputs, Ministry of Health, Brasília, Brazil
| | | | - Roberto Carreiro
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Mauricio Lima Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Djanilson Barbosa Santos
- Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Center for Health Sciences, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
- *Correspondence: Djanilson Barbosa Santos,
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Tanaka Y, Matsubara T, Atsumi T, Amano K, Ishiguro N, Sugiyama E, Yamaoka K, Combe BG, Kivitz AJ, Bae SC, Keystone EC, Nash P, Genovese M, Matzkies F, Bartok B, Pechonkina A, Kondo A, Ye L, Gong Q, Tasset C, Takeuchi T. Safety and Efficacy of Filgotinib for Japanese Patients with RA and Inadequate Response to MTX: FINCH 1 52-Week Results and FINCH 4 48-Week Results. Mod Rheumatol 2022:6653672. [PMID: 35920102 DOI: 10.1093/mr/roac084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/29/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To present safety and efficacy of the JAK1 preferential inhibitor filgotinib in Japanese patients with prior inadequate response (IR) to methotrexate (MTX) from a 52-week randomised controlled parent study (PS) and long-term extension (LTE) through June 2020. METHODS The PS (NCT02889796) randomised MTX-IR patients to filgotinib 200 (FIL200) or 100 mg (FIL100), adalimumab (ADA) 40 mg, or placebo; all took stable background MTX. At week (W) 24, placebo patients were rerandomised to FIL200 or FIL100. The primary endpoint was W12 American College of Rheumatology 20% improvement (ACR20); safety was assessed by adverse event (AE) reporting. For the LTE (NCT03025308), eligible filgotinib patients continued FIL200/FIL100; ADA patients were rerandomised (blinded) to FIL200 or FIL100; all continued MTX. RESULTS 114/147 Japanese patients completed the PS; 115 enrolled in LTE; 103 remained on study in June 2020. In the PS, AEs were consistent with the overall population, and W24 efficacy was maintained or improved through W52, comparable with the overall population. LTE AE incidences were similar between doses; filgotinib efficacy was consistent from baseline to W48 and similar between PS ADA and filgotinib patients. CONCLUSION Among MTX-IR Japanese patients, filgotinib maintained efficacy over 1 year; LTE safety was consistent with the PS.
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Affiliation(s)
- Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tsukasa Matsubara
- Department of Orthopedics, Matsubara Mayflower Hospital, Kato, Hyogo, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Naoki Ishiguro
- Aichi Developmental Disability Center, Kasugai, Aichi, Japan
| | - Eiji Sugiyama
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Bernard G Combe
- Rheumatology Department, CHU Montpellier, Montpellier University, du Doyen Gaston Giraud, Montpellier, France
| | - Alan J Kivitz
- Altoona Center for Clinical Research, Duncansville, USA
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology Research and Hanyang University Institute of Bioscience and Biotechnology, Seoul, Korea
| | | | - Peter Nash
- Griffith University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | | | | | - Lei Ye
- Gilead Sciences Inc., Foster City, USA
| | - Qi Gong
- Gilead Sciences Inc., Foster City, USA
| | | | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, and Saitama Medical University, Iruma, Saitama, Japan
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9
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Atsumi T, Tanaka Y, Matsubara T, Amano K, Ishiguro N, Sugiyama E, Yamaoka K, Westhovens R, Ching DWT, Messina OD, Burmester GR, Genovese M, Bartok B, Pechonkina A, Kondo A, Yin Z, Gong Q, Tasset C, Takeuchi T. Long-Term Safety and Efficacy of Filgotinib Treatment for Rheumatoid Arthritis in Japanese Patients Naïve to MTX Treatment (FINCH 3). Mod Rheumatol 2022:6654741. [PMID: 35921235 DOI: 10.1093/mr/roac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To evaluate long-term safety and efficacy of filgotinib for Japanese patients with rheumatoid arthritis (RA) and limited/no prior methotrexate (MTX) exposure. We present a Japanese population subanalysis of a global randomised-controlled trial at Week 52 and interim long-term extension (LTE) to Week 48 through June 2020. METHODS Patients were randomised to filgotinib 200 mg plus MTX, filgotinib 100 mg plus MTX, filgotinib 200 mg, or MTX for 52 weeks. At completion, eligible patients could enrol in the LTE. Those receiving filgotinib continued; those receiving MTX were rerandomised (blinded) to filgotinib 200 or 100 mg upon discontinuation of MTX. After a 4-week washout period, MTX could be re-added. RESULTS Adverse event rates at Week 52 and in the LTE to Week 48 were comparable across treatment groups. Week 52 American College of Rheumatology 20% improvement (ACR20) rates were 83% (19/23), 82% (9/11), 75% (9/12), and 76% (19/25) for filgotinib 200 mg plus MTX, filgotinib 100 mg plus MTX, filgotinib 200 mg, and MTX, respectively. Through LTE Week 48, ACR20 rates were maintained. CONCLUSIONS In the 56 Japanese patients treated with filgotinib, efficacy was maintained through Week 52 and beyond, with no increases in the incidence of adverse events.
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Affiliation(s)
- Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tsukasa Matsubara
- Department of Orthopedics, Matsubara Mayflower Hospital, Hyogo, Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Naoki Ishiguro
- Aichi Developmental Disability Center, Kasugai, Aichi, Japan
| | - Eiji Sugiyama
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases Kitasato University School of Medicine, Kanagawa, Japan
| | - René Westhovens
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Flanders, Belgium
| | - Daniel W T Ching
- Timaru Medical Specialists Limited, Level 1, Timaru, New Zealand
| | - Osvaldo Daniel Messina
- Cosme Argerich Hospital and Investigaciones Reumatologicas y Osteologicas SRL IRO, Buenos Aires, Argentina
| | - Gerd R Burmester
- Department of Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Free University and Humboldt University, Berlin, Germany
| | | | | | | | | | | | - Qi Gong
- Gilead Sciences Inc., Foster, USA
| | | | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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10
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Yamaguchi R, Tanaka E, Nakajima A, Inoue E, Abe M, Sugano E, Sugitani N, Saka K, Ochiai M, Higuchi Y, Sugimoto N, Ikari K, Yamanaka H, Harigai M. Risk of herpes zoster in patients with rheumatoid arthritis in the biologics era from 2011 to 2015 and its association with methotrexate, biologics, and corticosteroids. Mod Rheumatol 2021; 32:522-527. [PMID: 34897494 DOI: 10.1093/mr/roab026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/03/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To elucidate the incidence and risk factors of herpes zoster (HZ) in patients with rheumatoid arthritis (RA) in the biologics era. METHODS We determined the rate of HZ occurrence among the RA patients that participated in the Institute of Rheumatology, Rheumatoid Arthritis surveys from 2011 to 2015, by assessing medical records. The standardised incidence rate per 1000 patient-years with a 95% confidence interval (CI) was calculated, and risk factors for HZ were analysed using a time-dependent Cox regression analysis. RESULTS Among 7815 patients (female, 84.7%) contributing to 25,863 patient-years of observation, 340 HZ events in 309 patients were confirmed. The standardised incidence rate (95% CI) per 1000 patient-years was 8.5 (6.9-10.5) in total, 6.0 (3.7-9.2) in men, and 11.0 (8.7-13.7) in women. Risk factors for HZ were age per 10 years (hazard ratio 1.14, 95% CI 1.03-1.26, p < .05), Japanese version of the Health Assessment Questionnaire (J-HAQ) score of 0.5-1.5 (versus J-HAQ = 0; 1.51, 1.09-2.10, p < .05), methotrexate use (1.58, 1.06-2.36, p < .05), and biologic use (1.88, 1.44-2.47, p < .01). CONCLUSIONS In the era when biologics were frequently used and corticosteroid use and doses were decreasing, methotrexate and biologics increased the risk for HZ.
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Affiliation(s)
- Rei Yamaguchi
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Eiichi Tanaka
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Ayako Nakajima
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Center for Rheumatic Disease, Mie University Hospital, Mie, Japan
| | - Eisuke Inoue
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Research Administration Center, Showa University, Tokyo, Japan
| | - Mai Abe
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Eri Sugano
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Naohiro Sugitani
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Kumiko Saka
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Moeko Ochiai
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yoko Higuchi
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Naoki Sugimoto
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Katsunori Ikari
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisashi Yamanaka
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Rheumatology, Sanno Medical Center, Tokyo, Japan.,Department of Rheumatology, International University of Health and Welfare, Tokyo, Japan
| | - Masayoshi Harigai
- Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan
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11
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Tanaka Y, Matsubara T, Atsumi T, Amano K, Ishiguro N, Sugiyama E, Yamaoka K, Combe BG, Kivitz AJ, Bae SC, Keystone EC, Nash P, Matzkies F, Bartok B, Pechonkina A, Kondo A, Ye L, Guo Y, Tasset C, Sundy JS, Takeuchi T. Efficacy and safety of filgotinib in combination with methotrexate in Japanese patients with active rheumatoid arthritis who have an inadequate response to methotrexate: Subpopulation analyses of 24-week data of a global phase 3 study (FINCH 1). Mod Rheumatol 2021; 32:263-272. [PMID: 34910188 DOI: 10.1093/mr/roab030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Evaluate the efficacy and safety of the Janus kinase-1 inhibitor filgotinib in Japanese patients with rheumatoid arthritis (RA) and inadequate response to methotrexate (MTX). METHODS Data from 147 Japanese patients in FINCH 1, a 52-week global Phase 3 study, were analysed up to 24 weeks. Patients received once-daily filgotinib 200 or 100 mg, biweekly adalimumab, or placebo, all with stable background MTX. RESULTS In the Japanese population, American College of Rheumatology 20% response rates at Week 12 (primary endpoint) were 77.5%, 65.9%, 53.6%, and 36.8% for filgotinib 200 mg, filgotinib 100 mg, adalimumab, and placebo. Proportions of patients achieving Disease Activity Score with 28 joints <2.6 at Week 24: filgotinib 200 mg, 65.0%; filgotinib 100 mg, 51.2%; adalimumab, 42.9%; and placebo, 5.3%. Incidence rates of serious infections: filgotinib 200 mg, 2.5%; filgotinib 100 mg, 0%; adalimumab, 10.7%; and placebo, 5.3%. Treatment-emergent laboratory abnormalities Grade ≥3 occurred in five (12.5%) filgotinib 200 mg, three (7.3%) filgotinib 100 mg, one (3.6%) adalimumab, and no placebo patients. No deaths were reported among Japanese patients. CONCLUSIONS Filgotinib once daily combined with MTX was effective and generally safe and well tolerated up to Week 24 in Japanese patients with RA and inadequate response to MTX.
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Affiliation(s)
- Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tsukasa Matsubara
- Department of Orthopedics, Matsubara Mayflower Hospital, Hyogo, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Koichi Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | - Eiji Sugiyama
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kunihiro Yamaoka
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Bernard G Combe
- Rheumatology Department, CHU Montpellier, Montpellier University, Montpellier, France
| | - Alan J Kivitz
- Altoona Center for Clinical Research, Duncansville, PA, USA
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Edward C Keystone
- Department of Medicine, University of Toronto, Mount Sinai Hospital, Toronto, Canada
| | - Peter Nash
- Griffith University of Queensland, Brisbane, Australia
| | | | | | | | - Akira Kondo
- Gilead Sciences K.K, Gran Tokyo South Tower, Tokyo, Japan
| | - Lei Ye
- Gilead Sciences Inc, Foster City, CA, USA
| | - Ying Guo
- Gilead Sciences Inc, Foster City, CA, USA
| | | | - John S Sundy
- Gilead Sciences Inc, Foster City, CA, USA.,Department of Medicine, Duke University Medical Center, Durham, NC, USA.,Aichi Developmental Disability Center, Aichi, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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12
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Tanaka K, Kimura E, Oryoji K, Mizuki SI, Kobayashi T, Nishikawa A, Yoshinaga E, Miyake Y. Hypertension and dyslipidemia are risk factors for herpes zoster in patients with rheumatoid arthritis: a retrospective analysis using a medical information database. Rheumatol Int 2021; 41:1633-1639. [PMID: 34091702 PMCID: PMC8316192 DOI: 10.1007/s00296-021-04889-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022]
Abstract
This study used data from a large-scale multicenter medical information database in Japan to estimate the incidence rate of herpes zoster (HZ) and to examine the relationship between hypertension, dyslipidemia, and diabetes mellitus (DM), and the risk of HZ among patients with rheumatoid arthritis (RA). The research dataset consisted of 221,196 records of potential target patients with RA extracted between April 1, 2008 and August 31, 2017 from the Medical Data Vision database. To assess the association between hypertension, dyslipidemia, and DM and the risk of HZ, a case–control study was set up. Records of 101,498 study subjects met the inclusion criteria. During the observation period, 2566 patients developed HZ and the overall incidence rate was 5.2 (95% confidence interval: 5.0–5.4 per 1000 patient-years). Hypertension, dyslipidemia, and DM were significantly associated with an increased risk of HZ after adjustment for sex, age, hospital size, and use of anti-rheumatic drugs. When mutual adjustment was made for hypertension, dyslipidemia, and DM, the positive associations between hypertension and dyslipidemia and the risk of HZ remained significant; however, the positive association with DM completely disappeared. RA patients with hypertension or dyslipidemia may be at higher risk of HZ.
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Affiliation(s)
- Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. .,Research Promotion Unit, Translation Research Center, Ehime University Hospital, Ehime, Japan. .,Center for Data Science, Ehime University, Ehime, Japan.
| | - Eizen Kimura
- Center for Data Science, Ehime University, Ehime, Japan.,National Institute of Public Health, Saitama, Japan.,Department of Medical Informatics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kensuke Oryoji
- Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
| | - Shin-Ichi Mizuki
- Center for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
| | - Tomoko Kobayashi
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Hyogo, Japan
| | - Atsushi Nishikawa
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Hyogo, Japan
| | - Eiko Yoshinaga
- Medicines Development Unit Japan and Medical Affairs, Eli Lilly Japan K.K, Hyogo, Japan
| | - Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.,Research Promotion Unit, Translation Research Center, Ehime University Hospital, Ehime, Japan.,Center for Data Science, Ehime University, Ehime, Japan
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13
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Imafuku S, Dormal G, Goto Y, Jégou C, Rosillon D, Matsuki T. Risk of herpes zoster in the Japanese population with immunocompromising and chronic disease conditions: Results from a claims database cohort study, from 2005 to 2014. J Dermatol 2020; 47:236-244. [PMID: 31953880 DOI: 10.1111/1346-8138.15214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/05/2019] [Indexed: 01/10/2023]
Abstract
Older adults, women and patients with immunocompromised (IC) or chronic medical conditions have a higher incidence of herpes zoster (HZ) and are at higher risk of developing HZ-associated complications such as postherpetic neuralgia. The incidence rates of HZ in various IC and chronic conditions have been previously reported in a retrospective cohort study using claims data from Japanese adults. Here, we report further analyses from this cohort using univariate and multivariable Cox regression to estimate crude and adjusted hazard ratios (HRs) associated with different IC and chronic conditions. After adjusting for multiple covariates (age, sex and other coexisting medical conditions), the risk of HZ was higher in women (HR, 1.14 [95% CI, 1.11-1.17]), irrespective of age and increased with increasing age, being substantially higher in patients aged 65 years or older (HR, 3.28 [95% CI, 3.07-3.49]) when compared with those aged 18-29 years. The highest HRs were observed for the following specific IC conditions; hematopoietic stem cell transplant recipients (HR, 9.85 [95% CI, 6.80-14.28]), hematological malignancy (HR, 3.22 [95% CI, 2.54-4.09]), systemic lupus erythematosus (HR, 2.46 [95% CI, 1.45-4.15]) and inflammatory bowel disease (HR, 1.59 [95% CI, 1.14-2.21]). For most other IC and chronic medical conditions, a higher risk was also apparent though of a smaller magnitude (HRs ranging from 1.2 to <1.5). These results corroborate our previous findings and demonstrate an increased risk of HZ associated with different IC and chronic conditions.
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Affiliation(s)
- Shinichi Imafuku
- Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Giulia Dormal
- Business and Decision Life Sciences C/O GSK, Wavre, Belgium
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Céline Jégou
- Business and Decision Life Sciences C/O GSK, Wavre, Belgium
| | | | - Taizo Matsuki
- Value Evidence Outcomes Department, GSK, Tokyo, Japan
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14
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Furer V, Rondaan C, Heijstek M, van Assen S, Bijl M, Agmon-Levin N, Breedveld FC, D'Amelio R, Dougados M, Kapetanovic MC, van Laar JM, Ladefoged de Thurah A, Landewé R, Molto A, Müller-Ladner U, Schreiber K, Smolar L, Walker J, Warnatz K, Wulffraat NM, Elkayam O. Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. RMD Open 2019; 5:e001041. [PMID: 31673420 PMCID: PMC6803008 DOI: 10.1136/rmdopen-2019-001041] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 12/18/2022] Open
Abstract
Objectives The aims of this study were to update the evidence on the incidence and prevalence rates of vaccine preventable infections (VPI) in patients with autoimmune inflammatory rheumatic diseases (AIIRD) and compare the data to the general population when available. Methods A literature search was performed using Medline, Embase and Cochrane library (October 2009 to August 2018). The primary outcome was the incidence or prevalence of VPI in the adult AIIRD population. Meta-analysis was performed when appropriate. Results Sixty-three publications out of 3876 identified records met the inclusion criteria: influenza (n=4), pneumococcal disease (n=7), hepatitis B (n=10), herpes zoster (HZ) (n=29), human papillomavirus (HPV) infection (n=13). An increased incidence of influenza and pneumococcal disease was reported in patients with AIIRD. HZ infection-pooled incidence rate ratio (IRR) was 2.9 (95% CI 2.4 to 3.3) in patients with AIIRD versus general population. Among AIIRD, inflammatory myositis conferred the highest incidence rate (IR) of HZ (pooled IRR 5.1, 95% CI 4.3 to 5.9), followed by systemic lupus erythematosus (SLE) (pooled IRR 4.0, 95% CI 2.3 to 5.7) and rheumatoid arthritis (pooled IRR 2.3, 95% CI 2.1 to 2.6). HPV infection-pooled prevalence ratio was 1.6, 95% CI 0.7 to 3.4 versus general population, based on studies mainly conducted in the SLE population in Latin America and Asia. Pooled prevalence of hepatitis B surface antigen and hepatitis B core antibody in patients with AIIRD was similar to the general population, 3%, 95% CI 1% to 5% and 15%, 95% CI 7% to 26%, respectively. Conclusion Current evidence shows an increased risk of VPI in patients with AIIRD, emphasising that prevention of infections is essential in these patients.
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Affiliation(s)
- Victoria Furer
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Christien Rondaan
- Medical Microbiology and Infection Prevention, UMCG, Groningen, The Netherlands.,Rheumatology and Clinical Immunology, UMCG, Groningen, The Netherlands
| | - Marloes Heijstek
- Internal Medicine and Allergology, Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, The Netherlands
| | - Sander van Assen
- Internal Medicine (Infectious Diseases), Treant Care Group, Hoogeveen, The Netherlands
| | - Marc Bijl
- Internal Medicine, Martini Hospital, Groningen, The Netherlands
| | - Nancy Agmon-Levin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Ferdinand C Breedveld
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Raffaele D'Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza University of Rome, Roma, Italy
| | - Maxime Dougados
- Department of Rheumatology, Hôpital Cochin, Université Paris Descartes, Paris, France
| | - Meliha Crnkic Kapetanovic
- Department of Clinical Sciences Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Jacob M van Laar
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | | | - Robert Landewé
- Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Rheumatology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Anna Molto
- Department of Rheumatology, Hôpital Cochin, Université Paris Descartes, Paris, France
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig-University, Giessen, Germany
| | - Karen Schreiber
- Department of Rheumatology, King Christian X's Hospital for Rheumatic Diseases, Graasten, Denmark.,Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, United Kingdom
| | | | | | - Klaus Warnatz
- Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, University Medical Center Freiburg, Freiburg, Germany
| | - Nico M Wulffraat
- Department of Pediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ori Elkayam
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Sakai R, Kasai S, Hirano F, Harada S, Kihara M, Yokoyama W, Tsutsumino M, Nagasaka K, Koike R, Yamanaka H, Miyasaka N, Harigai M. No increased risk of herpes zoster in TNF inhibitor and non-TNF inhibitor users with rheumatoid arthritis: epidemiological study using the Japanese health insurance database. Int J Rheum Dis 2018; 21:1670-1677. [PMID: 29667330 DOI: 10.1111/1756-185x.13300] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE It is controversial whether the use of biological disease-modifying antirheumatic drugs (DMARDs) increases the risk of herpes zoster (HZ). We aimed to evaluate the risks of HZ in tumor necrosis factor inhibitor (TNFI) and non-TNFI users with rheumatoid arthritis (RA) over 3 years in Japan. METHOD Using the Japanese health insurance database, we assigned patients with at least one RA diagnostic code and one prescription for any DMARDs (RA cases) recorded between January 2005 and December 2013 to the RA group. We randomly selected five age-, sex-, calendar year- and observation length-matched non-RA cases for each RA case (non-RA group), and assessed associations between RA and HZ. To evaluate the risks of HZ in TNFI and non-TNFI users, we conducted a nested case-control study (NCC) in the RA group. RESULTS The RA group (n = 6712) had a significantly higher crude incidence rate of HZ than the non-RA group (n = 33 560) (14.2 vs. 8.3/1000 patient-years), and the adjusted odds ratio (95% confidence interval) of the RA versus non-RA groups was 1.43 (1.17-1.75). The NCC demonstrated that use of TNFI, non-TNFI, methotrexate, or immunosuppressive DMARDs did not increase the risks of HZ. Use of corticosteroid ≥ 5 mg/day conveyed a significant risk of HZ in patients with RA. CONCLUSIONS Rheumatoid arthritis was significantly associated with the development of HZ, and use of corticosteroids ≥ 5 mg/day was identified as a significant risk factor, whereas either TNFI or non-TNFI use were not.
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Affiliation(s)
- Ryoko Sakai
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Shoko Kasai
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Fumio Hirano
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sayoko Harada
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Mari Kihara
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Waka Yokoyama
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michi Tsutsumino
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Nagasaka
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuji Koike
- Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hisashi Yamanaka
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Masayoshi Harigai
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
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16
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Arleevskaya MI, Shafigullina AZ, Filina YV, Lemerle J, Renaudineau Y. Associations between Viral Infection History Symptoms, Granulocyte Reactive Oxygen Species Activity, and Active Rheumatoid Arthritis Disease in Untreated Women at Onset: Results from a Longitudinal Cohort Study of Tatarstan Women. Front Immunol 2017; 8:1725. [PMID: 29259607 PMCID: PMC5723296 DOI: 10.3389/fimmu.2017.01725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 11/22/2017] [Indexed: 02/02/2023] Open
Abstract
To evaluate the effects of infectious episodes at early stages of rheumatoid arthritis (eRA) development, 59 untreated eRA patients, 77 first-degree relatives, from a longitudinal Tatarstan women cohort, were included, and compared to 67 healthy women without rheumatoid arthritis (RA) in their family history. At inclusion, informations were collected regarding both the type and incidence of infectious symptom episodes in the preceding year, and granulocyte reactive oxygen species (ROS) were studied at the basal level and after stimulation with serum-treated zymosan (STZ). In the eRA group, clinical [disease activity score (DAS28), health assessment questionnaire] and biological parameters associated with inflammation (erythrocyte sedimentation rate, C-reactive protein) or with RA [rheumatoid factor, anticyclic citrullinated peptide (anti-CCP2) antibodies] were evaluated. An elevated incidence of infection events in the previous year characterized the eRA and relative groups. In addition, a history of herpes simplex virus (HSV) episodes was associated with disease activity, while an elevated incidence of anti-CCP2 autoantibody characterized eRA patients with a history of viral upper respiratory tract infection symptoms (V-URI). Granulocyte ROS activity in eRA patients was quantitatively [STZ peak and its area under the curve (AUC)] and qualitatively (STZ time of peak) altered, positively correlated with disease activity, and parameters were associated with viral symptoms including HSV exacerbation/recurrence, and V-URI. In conclusion, our study provides arguments to consider a history of increased viral infection symptoms in RA at the early stage and such involvement needs to be studied further.
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Affiliation(s)
| | | | - Yulia V. Filina
- State Medical Academy, Kazan, Russia
- Kazan Federal University, Kazan, Russia
| | - Julie Lemerle
- Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Régional Universitaire (CHU) de Brest, Brest, France
| | - Yves Renaudineau
- State Medical Academy, Kazan, Russia
- Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Régional Universitaire (CHU) de Brest, Brest, France
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