期刊
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
卷 77, 期 2, 页码 302-309出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2017.03.023
关键词
herpes zoster; JAK; psoriasis; shingles; tofacitinib
类别
资金
- Pfizer Inc.
Background: Tofacitinib is an oral Janus kinase (JAK) inhibitor. Immunomodulatory therapies can increase the risk for herpes zoster (HZ) in patients with psoriasis. Objective: To evaluate the relationship between tofacitinib use and HZ risk. Methods: We used phases 2 and 3 and long-term extension (LTE) data from the tofacitinib development program in psoriasis to calculate HZ incidence rates (IR; events per 100 patient-years); potential HZ risk factors were evaluated using Cox-proportional hazard models. Results: One hundred thirty (3.6%) patients on tofacitinib (IR 2.55), no patients on placebo, and 2 using etanercept (IR 2.68) developed HZ. Nine patients (7%) were hospitalized, and 8 (6%) had multidermatomal HZ; no encephalitis, visceral involvement, or deaths occurred. In total, 121 (93%) patients on tofacitinib continued or resumed use after HZ. HZ risk factors included Asian descent (hazard ratio [HR] 2.92), using tofacitinib 10 mg twice daily (vs 5 mg twice daily; HR 1.72), prior use of biologics (HR 1.72), and older age (HR 1.30). Limitations: Generalizability to other psoriasis populations might be limited. The effect of HZ vaccination was not studied. Conclusion: Tofacitinib is associated with increased HZ risk relative to placebo. Asian race, increasing age, higher dose, and prior biologic exposure are associated with heightened risk.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据