Rheumatoid Arthritis Medication Can Cause Shingles Outbreak


After a case of chickenpox, the virus that causes the disease — varicella zoster virus (VZV) — is never fully eliminated by the body. It hides in the nervous system but causes no harm unless it is reactivated by circumstances like stress, chemotherapy, or cancer. Then VZV can erupt into the often excruciating skin condition called shingles.

Now a new study just published in the Journal of the American Medical Association (JAMA), concludes a prescription medication used to treat rheumatoid arthritis (RA) appears to increase the risk of shingles, also known as herpes zoster. The class of drugs implicated in activating the virus is known as monoclonal anti-tumor necrosis factor (anti-TNF) antibodies. They have previously been implicated in causing an increase in serious bacterial infections such as tuberculosis, nocardiosis and listeriosis, as well as fungal infections, including candidiasis.

Anja Strangfeld, M.D., of the German Rheumatism Research Center, Berlin, and her research team studied a total of 5,040 RA patients in order to investigate the association of various rheumatoid arthritis treatments, including anti-TNF drugs, with the risk of shingles. The scientists reported a significant association between herpes zoster and treatment with the monoclonal anti-tumor necrosis factor antibodies infliximab and adalimumab. In fact, herpes zoster was one of the most common adverse events reported in clinical trials of anti-TNF agents, according to background information provided in the JAMA article.

The rheumatoid arthritis patients found to be at highest risk for shingles were those who were older and who were also being treated with steroid hormones called glucocorticoids that are widely prescribed to RA sufferers as anti-inflammatory medications. “Based on our data, we recommend careful monitoring of patients treated with monoclonal anti-TNF antibodies for early signs and symptoms of herpes zoster,” the study’s authors stated in a release to the media.

Although shingles isn’t a life-threatening illness, it can sometimes result in a debilitating complication called postherpetic neuralgia which causes nerve pain that lasts for months or even years. Fortunately, there is natural help for shingles, whatever the cause of the reactivation. According to the University of Maryland Medical Center web site, lysine can be used to treat herpes zoster lesions. Lysine, also called L-lysine, is an essential amino acid that can speed recovery time from shingles and reduce the chance of recurrent breakouts of the herpes infections, the University of Maryland site states.

Article by Sherry Baker, Health Sciences Editor

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