The increased risk of infection with herpes zoster virus in patients with rheumatoid arthritis (RA) treated with the Janus kinase inhibitor tofacitinib is further increased by the concomitant use of glucocorticoids. In a study of 8,030 patients with RA in the USA treated with tofacitinib, additional glucocorticoid use nearly doubled the risk of herpes zoster infection (HR = 1.96, 95% CI 1.33-2.88), whereas additional methotrexate use did not increase the risk of herpes zoster infection (HR = 0.99, 95% CI 0.64-1.54).
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Curtis, J. R. et al. Herpes zoster in tofacitinib: risk is further increased with glucocorticoids but not methotrexate. Arthritis Care Res. https://doi.org/10.1002/acr.23769 (2018)
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Collison, J. Infection risk with tofacitinib plus glucocorticoid. Nat Rev Rheumatol 14, 684 (2018). https://doi.org/10.1038/s41584-018-0118-1
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DOI: https://doi.org/10.1038/s41584-018-0118-1
