FRI0038 HERPES ZOSTER IN RHEUMATOID ARTHRITIS. PROSPECTIVE SINGLE CENTER STUDY OF 390 RA PATIENTS FOR 5YEARS
Authors: Lucia Domínguez, Vanesa Calvo-Río, Paz Rodriguez-Cundin, Virginia Portilla, Nuria Vegas-Revenga, Francisco Manuel Antolin-Juarez, Francisco Manuel Antolin-Juarez, Alfonso Corrales, D. Prieto-Peña, Monica Calderón-Goercke, Miguel A. González-Gay, Ricardo Blanco
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Immunosuppressed patients such as Rheumatoid Arthritis (RA) patients have a greater risk (1.5-2 times) of presenting herpes zoster (HZ). Both, the disease itself and the use of immunosuppressive drugs, are involve in this increased risk. Furthermore, in these patients is more frequent a disseminated presentation of zoster involving several dermatomes. <h3>Objectives</h3> In a series of RA patients our aim was analyzed HZ infections and to assess <b>a)</b> HZ prevalence and <b>b)</b> HZ general features <h3>Methods</h3> Prospective Single center study of 390 RA patients included in the vaccination program of the Preventive and Rheumatology department of our hospital between october 2011 and october 2016. The follow-up was made until December 2017. HZ vaccination is not included in our program. RA was diagnosed according to the ACR/EULAR 2010 proposed criteria (Arthritis Rheum 2010; 62: 2569–2581) The diagnose of HZ was made according to the clinical manifestations and was confirmed by a dermatologist. These manifestations were characteristic skin rash and blisters, paresthesia and local pain, in one (localized) or more dermatomes (generalized) <h3>Results</h3> We studied 390 patients (307♀/83♂), average age 61.28±12.9 years that were included in the vaccination program and followed-up. HZ infection was observed in 12 of 390 (3.07%) in the follow-up <b>(TABLE).</b> The 12 RA patients (11 women/1 man) with a mean±SD age of 67.5±11.67. More than half of patients, 7 (58.33%) were taking corticosteroids. 8 patients (66.66%) were receiving conventional disease modifying drugs (DMARDs) methotrexate (33.33%), leflunomide (16.66%) and hydroxychloroquine (16.66%). Besides corticosteroids and conventional DMARDs, 7 patients (58.33%) were in treatment with biologic drugs, tocilizumab (n=2), etanercept (n=2), adalimumab (n=2), and rituximab (n=1). <h3>Conclusion</h3> Herpes zoster is a relative frequent viral infection in RA patients non-vaccine for HZ. The female sex, older age, more aggressive RA and treatment with corticosteroids were more frequent. Probably in this group of patients HZ vaccination may be useful. Abbreviatures: MTX: methotrexate, LFN: leflunomide, HCQ: hydroxicloroquine, TCZ: tocilizumbas, ADA: adalimumab, ETN: etanercept <h3> Disclosure of Interests: </h3> Lucia Domínguez: None declared, Vanesa Calvo-Río: None declared, Paz Rodriguez-Cundin: None declared, Virginia Portilla: None declared, Nuria Vegas-Revenga: None declared, Francisco Manuel Antolin-Juarez: None declared, Maria Henar Rebollo Rodriguez: None declared, Alfonso Corrales: None declared, D. Prieto-Peña: None declared, Monica Calderón-Goercke: None declared, Miguel A González-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker's bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ricardo Blanco Grant/research support from: Abbvie, MSD, and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen