Doctors urge shingles vaccine to be used in arthritis patients

Patients with rheumatoid arthritis have a higher risk of developing shingles compared to adults without rheumatoid arthritis.

By Amy Wallace

Aug. 28 (UPI) -- Researchers at Oregon Health and Science University found that the live varicella-zoster, or shingles, vaccine boosts the immune response in arthritis patients.

The study, published today in Arthritis & Rheumatology, found that the shingles vaccine given several weeks before the start of treatment with the arthritis drug tofacitinib elicits a robust immune response in patients.


Patients with rheumatoid arthritis have a higher risk of developing shingles, and tofacitinib and certain other disease-modifying antirheumatic drugs may further increase the risk.

For the study, researchers vaccinated 112 patients with active rheumatoid arthritis with the shingles vaccine and then randomized them to receive either tofacitinib or a placebo.

"We showed that the vaccine was adequately immunogenic in patients whether they were starting tofacitinib or placebo in a few weeks, and the immunogenicity and the response to the vaccine were similar to what we've seen outside the rheumatoid arthritis setting in general population studies," Dr. Kevin Winthrop, of the Oregon Health and Science University, said in a press release.

The study showed that patients had a significant immune response to the vaccine and the start of the tofacitinib treatment after vaccination had no negative impact on established immune response.


A second study by the team on the use of conventional synthetic-disease-modifying antirheumatic drugs, or csDMARDs, such as methotrexate and chloroquine or corticosteroids showed that shingles rates were lowest for patients taking tofacitinib along with csDMARDs and corticosteroids.

"If you want to lower shingles risk for rheumatoid arthritis patients, there are two strategies: one is vaccinating them and the other is getting them off steroids and methotrexate if you can," Winthrop said.

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