Anti-tumor necrosis factor alpha (TNF-alpha) drugs are the newest class of medications being used to treat Crohns disease and ulcerative colitis. These drugs, such as Remicade (infliximab) and Humira (adalimumab), have been shown to be effective in treating inflammatory bowel disease (IBD) and other inflammatory conditions. However, they have also been shown to increase the risk of certain types of infections, such as tuberculosis. Researchers in Germany have also recently found that these drugs also increase the risk of developing singles (herpes zoster).
The study was done on people with rheumatoid arthritis (RA) who were receiving either a TNF-alpha inhibitor (Remicade [infliximab] or Humira [adalimumab]), Kineret (anakinra), or a conventional RA medication (called disease-modifying antirheumatic drugs). What the authors discovered was that the risk of developing shingles was increased in those who were given the TNF-alpha inhibitors.
An Estimation Of The Risk
Risk of shingles increases with age, and the authors of an accompanying editorial estimate that the risk of developing shingles while taking an TNF-alpha inhibitor is the same as that for a person who is greater than 80 years old.
It is already known that TNF-alpha inhibitors are associated with an increased risk of developing a latent viral infection. However, in most cases the risks of these type of infections are still considered small when compared with the benefits these drugs provide.
Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, Zink A. "Risk of Herpes Zoster in Patients With Rheumatoid Arthritis Treated With AntiTNF-Agents." JAMA 2009;301:737-744. 20 Feb 2009.
Whitley RJ, Gnann JW. "Herpes Zoster in the Age of Focused Immunosuppressive Therapy." JAMA 2009;301:774-775. 20 Feb 2009.