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The global prevalence of rheumatoid arthritis (RA) is increasing, resulting in an increased use of Janus kinase (JAK) inhibitors. Several cases of varicella-zoster virus (VZV) pneumonia in patients with RA have been reported. However, to our knowledge, no reports have demonstrated conclusive evidence of VZV reinfection in this patient population.

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[Herpes zoster : vaccination and management of satellite lesions in immunocompromised patients].

Rev Med Liege

December 2024

Service de Dermatologie et Vénéréologie, CHU Liège, Belgique.

Shingles, also termed herpes zoster (HZ), is due to the reactivation of the varicella zoster virus (VZV) in a dorsal root nerve ganglion with an intra-axonal passage of the virus to a predetermined dermatome. The risk of HZ increases with age, as well as the morbidity risks. The most feared complication is post-herpetic neuralgia, defined as persisting pain sensations three months after the resolution of the skin lesions.

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: Janus kinase (JAK) inhibitors have emerged as a new class of disease-modifying anti-rheumatic drugs in the treatment of rheumatoid arthritis (RA). However, herpes zoster is one of the common adverse events of JAK inhibitors, including upadacitinib, which is especially high in Japanese patients with RA compared to those from Western countries. Recombinant zoster vaccine (Shingrix) is an adjuvanted subunit vaccine containing varicella-zoster virus (VZV) glycoprotein E (gE) that is effective in adults over 50 years of age.

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This post-marketing surveillance study evaluated the safety of the adjuvanted recombinant zoster vaccine (RZV) in Chinese adults, given the limited country-specific safety data accumulated since the 2019 licensure of RZV in China for adults ≥ 50 years of age (YOA). This descriptive, prospective cohort study enrolled adults ≥ 50 YOA who voluntarily received RZV per routine clinical practice in six centers in China. The primary outcomes were occurrence, intensity, and causal relationship to vaccination of medically attended adverse events (MAEs) within 30 days post-any dose.

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