PMID- 33560302
OWN - NLM
STAT- MEDLINE
DCOM- 20211228
LR  - 20211228
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
VI  - 60
IP  - 11
DP  - 2021 Nov 3
TI  - Safety of recombinant zoster vaccine: a retrospective study of 622 rheumatology 
      patients.
PG  - 5149-5157
LID - 10.1093/rheumatology/keab139 [doi]
AB  - OBJECTIVES: To provide insight into the safety of recombinant zoster vaccine 
      (RZV) in patients with immune-mediated inflammatory diseases (IMID). METHODS: 
      Patients who received RZV in a single-centre rheumatology department were 
      retrospectively included. An IMID flare was defined as (i) a documentation of 
      flare in the office notes or patient portal communication or (ii) new prednisone 
      prescription, in the 12 weeks after each dose. RESULTS: Six-hundred and 
      twenty-two patients were included (67% female, median age 67 years), 8.5% of them 
      experienced adverse events (AEs) and herpes zoster (HZ) incidence was 0.6% after 
      median follow-up of 36 weeks. Of 359 IMID patients: 88 had RA (25%), 50 
      vasculitis (14%) and 29 PMR (8%). At vaccination, 35% were on glucocorticoids 
      (GC). Fifty-nine patients (16%) experienced a flare, 18 flares occurred in 
      temporal relation to a treatment change (31%). RA patients had the highest flare 
      rate (n = 21, 24%), 25% of patients who flared required adjustment of 
      immunosuppression. In a multivariate analysis, use of GC at time of vaccination 
      was associated with flare after vaccination [odds ratio (OR) 2.31 (1.3-4.1), 
      P =0.004]. A time-to-flare survival analysis (Cox-model) showed that GC was a 
      significant predictor of IMID flare after first RZV dose [hazard ratio (HR) 2.4 
      (1.3-4.5), P =0.0039] and that a flare after the first dose was associated with 
      flaring after the second RZV dose [HR 3.9 (1.7-9), P =0.0015]. CONCLUSION: RZV 
      administration in patients with IMIDs was generally well-tolerated, though mild 
      flares were not uncommon in the first 12 weeks after vaccination. These data may 
      provide useful information for patient education when considering RZV 
      administration.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Lenfant, Tiphaine
AU  - Lenfant T
AD  - Department of Rheumatologic and Immunologic Diseases, Orthopedic & Rheumatologic 
      Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
AD  - Department of Internal Medicine, Hopital Europeen Georges Pomidou, AP-HP, 
      Universite de Paris, Paris, France.
FAU - Jin, Yuxuan
AU  - Jin Y
AD  - Department of Quantitative Health Sciences.
FAU - Kirchner, Elizabeth
AU  - Kirchner E
AD  - Department of Rheumatologic and Immunologic Diseases, Orthopedic & Rheumatologic 
      Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
FAU - Hajj-Ali, Rula A
AU  - Hajj-Ali RA
AD  - Department of Rheumatologic and Immunologic Diseases, Orthopedic & Rheumatologic 
      Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
FAU - Calabrese, Leonard H
AU  - Calabrese LH
AD  - Department of Rheumatologic and Immunologic Diseases, Orthopedic & Rheumatologic 
      Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
FAU - Calabrese, Cassandra
AU  - Calabrese C
AUID- ORCID: 0000-0002-8773-7739
AD  - Department of Rheumatologic and Immunologic Diseases, Orthopedic & Rheumatologic 
      Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
AD  - Department of Infectious Diseases, Cleveland Clinic Foundation, Cleveland, OH, 
      USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
RN  - 0 (Herpes Zoster Vaccine)
SB  - IM
MH  - Aged
MH  - Female
MH  - Herpes Zoster Vaccine/*adverse effects
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - *Rheumatic Diseases
MH  - *Symptom Flare Up
OTO - NOTNLM
OT  - Shingrix
OT  - herpes zoster
OT  - immune-mediated inflammatory disease
OT  - recombinant zoster vaccine
EDAT- 2021/02/10 06:00
MHDA- 2021/12/29 06:00
CRDT- 2021/02/09 12:10
PHST- 2020/10/01 00:00 [received]
PHST- 2021/01/18 00:00 [revised]
PHST- 2021/02/10 06:00 [pubmed]
PHST- 2021/12/29 06:00 [medline]
PHST- 2021/02/09 12:10 [entrez]
AID - 6131690 [pii]
AID - 10.1093/rheumatology/keab139 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2021 Nov 3;60(11):5149-5157. doi: 
      10.1093/rheumatology/keab139.