Protracted herpes zoster and severe postherpetic neuralgia after inadvertant infliximab administration

Failla, Valérie; Castronovo, Charlotte; Meex, Cécile; Nikkels, Arjen F.

doi:10.1684/ejd.2011.1424

Cited by 7 publications

(4 citation statements)

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“…In a retrospective analysis of patients with rheumatoid arthritis on anti-TNF treatment the number of PHN after herpes zoster was remarkably lower (only two cases out of 206) compared to data of the general population [13]. In contrast, the development of severe PHN was reported after inadvertent infliximab administration [24]. In a prospective study assessing the risk of herpes zoster in more than 5000 patients with rheumatoid arthritis treated with anti-TNF drugs, 86 episodes of herpes zoster were recorded in 82 patients; in two of these patients PHN occurred [14].…”

Section: Discussionmentioning

confidence: 80%

Local and Systemic Cytokine Expression in Patients with Postherpetic Neuralgia

et al. 2014

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BackgroundPostherpetic neuralgia (PHN) is the painful complication of a varicella zoster virus reactivation. We investigated the systemic and local gene expression of pro- and anti-inflammatory cytokine expression in patients with PHN.MethodsThirteen patients with PHN at the torso (Th4-S1) were recruited. Skin punch biopsies were obtained from the painful and the contralateral painless body area for intraepidermal nerve fiber density (IENFD) and cytokine profiling. Additionally, blood was withdrawn for systemic cytokine expression and compared to blood values of healthy controls. We analyzed the gene expression of selected pro- and anti-inflammatory cytokines (tumor necrosis factor-alpha [TNF] and interleukins [IL]-1β, IL-2, and IL-8).ResultsIENFD was lower in affected skin compared to unaffected skin (p<0.05), while local gene expression of pro- and anti-inflammatory cytokines did not differ except for two patients who had 7fold higher IL-6 and 10fold higher IL-10 gene expression in the affected skin compared to the contralateral unaffected skin sample. Also, the systemic expression of cytokines in patients with PHN and in healthy controls was similar.ConclusionWhile the systemic and local expression of the investigated pro- and anti-inflammatory cytokines was not different from controls, this may have been influenced by study limitations like the low number of patients and different disease durations. Furthermore, other cytokines or pain mediators need to be considered.

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Section: Discussionmentioning

confidence: 80%

Local and Systemic Cytokine Expression in Patients with Postherpetic Neuralgia

et al. 2014

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“…Through our search, we found nine case reports demonstrating HZ after the administration of infliximab (treating seven for IBD and two for RA), two case reports on etanercept (for RA) and a case series discussing two cases on ustekinumab (for plaque psoriasis) . No case reports were found on adalimumab.…”

Section: Resultsmentioning

confidence: 99%

The risk of herpes zoster during biological therapy for psoriasis and other inflammatory conditions

Adelzadeh

Jourabchi

2013

Acad Dermatol Venereol

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Recent advances in biological therapies have proved highly effective in treating psoriasis and other inflammatory conditions, including psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease and ankylosing spondylitis. However, adverse effects related to their immunosuppression have been observed, including an increased propensity to viral infections. This review evaluates the evidence of herpes zoster (HZ) risk from biologics based on clinical reports, cohort studies and randomized controlled studies. The risk of HZ associated with these agents remains controversial, especially when comparing their risk with non-biological therapy used to treat the same inflammatory conditions. This review specifically assesses the risk of the TNF inhibitors etanercept, adalimumab and infliximab, as well as interleukin-12/23 inhibitor ustekinumab. We found multiple cohort studies, randomized controlled trials and case reports that suggest infliximab increases risk of HZ, whereas adalimumab, etanercept and ustekinumab HZ risk remain controversial. Nevertheless, HZ vaccination should be considered prior to initiation of biological therapy, particularly infliximab.

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“…Indeed, some of the patients may present very severe HZ in terms of cutaneous extension inside the involved dermatome(s), multidermatomal involvement in adjacent dermatomes and nonadjacent dermatomes, and increased duration of the HZ skin lesions ( Figures 1 and 2 ). 26 – 29 , 38 , 39 , 42 , 43 In a study that identified 86 cases of HZ among 82 patients under biologicals, multidermatomal HZ was observed in 18.3% of patients, HZ ophthalmicus in 4.9%, and hospitalization due to severe disease in 14.6%. Complications were reported in three patients.…”

Section: Is the Severity Of Hz Increased In Psoriasis Patients Under mentioning

confidence: 99%

Herpes zoster in psoriasis patients undergoing treatment with biological agents: prevalence, impact, and management challenges

Hayderi¹,

Colson²,

Dezfoulian³

et al. 2016

PTT

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As TNF-α is a major factor in the immune defense against herpes zoster (HZ); an increased incidence and severity of HZ cases were suspected in patients undergoing treatment with TNF antagonists. Several studies and clinical experience provided evidence that the incidence of HZ increases by twofold to threefold in this patient category. The number of severe cases of HZ, with multisegmental, disseminated cutaneous, and/or systemic involvement, is also increased. Concerning psoriasis patients under biologicals, the clinician should be more alert for an eventual HZ event, in particular during the first year of biological treatment, and be aware of the possibility of more severe HZ cases. HZ may also undergo an age-shift toward younger patients. Rapid identification of risk factors for severe HZ, such as severe prodromal pains and/or the presence of satellite lesions, is recommended. The treatment recommendations of HZ in this patient group are identical to the recently published guidelines for the management of HZ. The live attenuated viral vaccine OKA/Merck strain anti-HZ vaccination is recommended before initiating biological treatment in psoriasis patients. The new adjuvanted anti-HZ vaccine will probably also benefit patients while on biological treatment.

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Protracted herpes zoster and severe postherpetic neuralgia after inadvertant infliximab administration

Cited by 7 publications

References 0 publications

Local and Systemic Cytokine Expression in Patients with Postherpetic Neuralgia

Local and Systemic Cytokine Expression in Patients with Postherpetic Neuralgia

The risk of herpes zoster during biological therapy for psoriasis and other inflammatory conditions

Herpes zoster in psoriasis patients undergoing treatment with biological agents: prevalence, impact, and management challenges

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