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Newer RA Drugs Don't Seem to Raise Shingles Risk

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Two other classes of drugs -- the "biologic" anti-TNF drugs and a group of medications called non-biologic disease-modifying anti-rheumatic drugs (DMARDs) -- are newer medications that can be used to treat rheumatoid arthritis and other autoimmune conditions. Examples of biologics are adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade). A commonly used DMARD is methotrexate.

Winthrop and his colleagues reviewed data from almost 60,000 people with various autoimmune conditions, such as rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis and ankylosing spondylitis. More than 33,000 were taking biologic anti-TNF drugs, and almost 26,000 were on DMARDs. The study period ran from 1998 through 2008.

They found no significant increase in the risk of shingles based on the type of medicine people were taking, with the exception of a high dose of corticosteroids. People taking more than 10 milligrams a day of corticosteroid medication had twice the odds of developing shingles.

Dr. Patience White, vice president of public health for the Arthritis Foundation, said the study's findings were good news.

"People worry a lot about taking drugs, and this well-done study says this is another thing we don't have to worry about," said White, who also is a professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences, in Washington, D.C. "Drug therapies, other than corticosteroids, don't increase the risk of getting [shingles]."

Both White and Winthrop said people, if possible, should get the shingles vaccine before they start taking medication for an autoimmune condition. The shingles vaccine is a live vaccine, so it's not recommended for people who are on any type of immune-system-altering drug.

Winthrop said that based on the latest findings, he suspects it would be OK to vaccinate people on the newer medications, but he added that a study would need to be done first to confirm that.

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