Immunosuppressive medication use and risk of herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE): A nationwide case-control study
| Autor: | Stephen Chu-Sung Hu, Feng-Lin Yen, Gwo-Shing Chen, Yu-Chih Lin, Chi-Ling Lin, Tsu-Nai Wang |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Cyclophosphamide Population Taiwan Administration Oral Azathioprine Dermatology Herpes Zoster Methylprednisolone Mycophenolic acid Young Adult 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Risk Factors Internal medicine medicine Humans Lupus Erythematosus Systemic 030212 general & internal medicine skin and connective tissue diseases education Retrospective Studies 030203 arthritis & rheumatology education.field_of_study Dose-Response Relationship Drug business.industry Hydroxychloroquine Retrospective cohort study Odds ratio Middle Aged Mycophenolic Acid Methotrexate Case-Control Studies Immunology Administration Intravenous Female business Immunosuppressive Agents medicine.drug |
| Zdroj: | Journal of the American Academy of Dermatology. 75:49-58 |
| ISSN: | 0190-9622 |
| DOI: | 10.1016/j.jaad.2015.12.059 |
| Popis: | Background The association between immunosuppressive medication use and herpes zoster (HZ) in patients with systemic lupus erythematosus (SLE) has not been clearly defined. Objective We evaluated the risk of HZ in patients with SLE treated with different immunosuppressants. Methods A nationwide population-based case-control study was conducted using the Taiwanese National Health Insurance Research Database. Cases (1555 patients with SLE who developed HZ) and controls (3049 age- and sex-matched patients with SLE but without HZ) were analyzed for use of various immunosuppressive medications in the preceding 3-month period, and dose-response relationships were determined. Logistic regression was performed to estimate the adjusted odds ratio for HZ development. Results Medications associated with greater HZ risk in patients with SLE included oral corticosteroids, intravenous methylprednisolone, hydroxychloroquine, oral cyclophosphamide, intravenous cyclophosphamide, azathioprine, methotrexate, and mycophenolate mofetil. Combination immunosuppressive therapy was common in patients with SLE and was associated with greatly increased HZ risk. For oral corticosteroids and hydroxychloroquine, the risk of HZ was strongly dependent on the medication dose. Limitations This study is retrospective in nature. Conclusion Recent immunosuppressive medication use is associated with increased HZ risk in patients with SLE, particularly those receiving high-dose oral corticosteroids and multiagent immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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