AAD: Herpes zoster incidence up with combo tx for psoriasis

(HealthDay)—For patients with psoriasis, combination treatment with biologic medications and methotrexate is associated with increased incidence of herpes zoster (HZ), according to a study published online March 22 in JAMA Dermatology. The research was published to coincide with the annual meeting of the American Academy of Dermatology, held from March 20 to 24 in San Francisco.

Guy Shalom, M.D., from the Soroka Medical Center in Beer-Sheva, Israel, and colleagues describe the risk for HZ in patients with psoriasis. Data were extracted for 95,941 patients with psoriasis, with 522,616 person-years of follow-up.

In multivariate analysis, the researchers observed no association with HZ for treatment with phototherapy (rate ratio [RR], 1.09; 95 percent confidence interval [CI], 0.62 to 1.93; P = 0.99), methotrexate (RR, 0.98; 95 percent CI, 0.78 to 1.23; P = 0.83), cyclosporine (RR, 1.16; 95 percent CI, 0.48 to 2.80; P = 0.49), and biologic medications as a single agent (RR, 2.67; 95 percent CI, 0.69 to 10.3; P = 0.14). The incidence of HZ was significantly increased with use of combination treatment with biologic medications and methotrexate (RR, 1.66; 95 percent CI, 1.08 to 2.57; P = 0.02). Acitritin use correlated with reduced incidence of HZ (RR, 0.69; 95 percent CI, 0.49 to 0.97 P = 0.004).

"Physicians may need to consider offering an HZ preventive vaccine to patients receiving combination treatment with biologic medications and methotrexate, particularly if they have additional risk factors for HZ," the authors write.

One author disclosed financial ties to the pharmaceutical industry.