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Amber J. Tresca

Humira and Remicade May Increase Risk of Shingles

By February 20, 2009

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Anti-tumor necrosis factor alpha (TNF-alpha) drugs are the newest class of medications being used to treat Crohn’s disease and ulcerative colitis. These drugs, such as Remicade (infliximab) and Humira (adalimumab), have been shown to be effective in treating 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.

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.

Source:
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 Anti–TNF-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.

Comments
February 23, 2009 at 12:39 pm
(1) Edith Guttmacher says:

Shingles attacked my right eye,damaging my Cornea.

March 19, 2009 at 1:18 pm
(2) Shawn says:

I am 34 yrs old and I had a Shingles outbreak after taking Humira for 20 months.

March 19, 2009 at 1:25 pm
(3) Shawn Reese says:

Correction to last comment: 10 months, not 20. Also, I talked to a representative from Abbott (Humira manufacturer) and she said they are seeing a fair amount of people getting Shingles while taking the drug. FYI, there is a Shingles vaccine that came out in 2006 – you may want to ask your doctor about getting the vaccine before starting Humira. The Humira does seem to work well at treating my Crohn’s Disease.

March 20, 2009 at 1:46 pm
(4) ibdcrohns says:

I think it’s interesting that they told you about the number of shingles cases. They must be getting a lot of calls. Maybe they will start recommending the vaccine for anyone who receives these drugs.

September 28, 2010 at 8:39 pm
(5) Scotty says:

Been taking Humira for Psoriasis for almost 2 years. Worked great. A few days ago I thought I had a new breakout after being clear for so long. Went to my derm. He took one look and said it was Shingles. I was half relieved half alarmed. This is torture but hopefully will only last a week (with ant-viral medication).

October 7, 2010 at 8:25 am
(6) Richard says:

Beware that you cannot take the Shingles vaccine while taking Humira (or the other TNF inhibitors like Enbrel, Remicade, etc.). The current Shingles vaccine is a live virus, so you need to take it (and wait) before starting Humira et. al.

There is work going on to make a ‘dead’ virus version of the Shingles vaccine, but no such vaccine is yet available.

Talk with your doctor before getting the Shingles vaccine (Zostafax).

I have RA, and just went through an attack of Shingles right as I was starting Humira. I should be able to start again in a week or two.

June 14, 2011 at 2:07 pm
(7) Coreen says:

I’m 47, been on Humeria for 15 months, got my first case of shingles 3 days after taking the shot. Does anyone know is this gonna happen every time I take a shot?

June 14, 2011 at 8:46 pm
(8) ibdcrohns says:

According to Symptom Checker, the chance of a recurrence is low — about 2%. You may want to ask your doctor about it, just to be sure. There is a vaccine for shingles now, but it’s typically only given to those over the age of 60.

September 5, 2011 at 10:28 pm
(9) WASP says:

Yes I was Remecade for a year and a half after losing my career of 25 years, and then my savings, in the Great Recession along with my medical insurance finally qualifying for County. But County just doesn’t seem to be approving renewals anymore here in CA so they just leave you in pending status month after month. Obviously, you lose all your medical care. It’s been over four months since my last Remecade infusion and I have no medical care of any kind. Shingles are erupting on me now. They hurt like you know what. I wonder if its serious?

February 29, 2012 at 12:01 am
(10) WASP says:

The shingles resolved fine thankfully. Stayed off Remecade and went on sulphasalazine. Have impetigo now. Bummer…

June 11, 2012 at 5:59 pm
(11) Laura says:

I’ve been taking remicade for a couple years now. About four months ago I had my first outbreak of shingles. I told my gastro doctor, of course. He never mentioned anything about shingles and remicade being related and i went ahead with my infusion. About a month and half to two months later i got a second outbreak of shingles. I never went back for another infusion because my immune system was destroyed. I’ve yet to talk to my doctor.

April 7, 2013 at 11:33 pm
(12) Granny says:

Why didn’t anyone alert me to the possibility of shingles connection and remicade? Had a long run on remicade 10.5 yrs. Too long probably. Had shingles once before when young and again in fall. I’m scared now and had a bad case and again the HP nerve pain upon swimming in a very clorine laden indoor pool and taking a couple hot showers. Stupid. Notice reacting to any irritants such as closed up smokey houses and too much heat. Will I ever feel normal again?

November 2, 2013 at 11:20 pm
(13) granny says:

I am beginning to feel I will never feel really too good again. Having stopped rem after shingles I am still dev post hep pain a year later and had another reo.shingles pain also irritating virus which is causing flare up. Whst is one to do?

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