Table 3.
Odds Ratios for the Risk of HZ According to Medications Used in Rheumatoid Arthritis Patients (N=8666)
| Variable | HZ Case (N=2892) | Control (N=5774) | Crude OR (95%CI) | P Value | Adjusted ORa (95%CI) | P Value |
|---|---|---|---|---|---|---|
| NSAID (ref: NSAID nonusers) | 2798 (96.7) | 5555 (96.2) | 1.17 (0.92‐1.50) | 0.20 | 1.18 (0.92‐1.51) | 0.18 |
| NSAID+other immunosuppressive medicationsb (ref: NSAID alone) | 2707 (96.8) | 5261 (94.7) | 1.66 (1.31‐2.11) | <0.0001c | 1.66 (1.30‐2.10) | <0.0001c |
| csDMARDs (ref: csDMARDs nonusers) | 2404 (83.1) | 4572 (79.2) | 1.30 (1.15‐1.45) | <0.0001c | 1.30 (1.16‐1.46) | <0.0001c |
| Methotrexate | 1319 (45.6) | 2278 (39.5) | 1.29 (1.18‐1.41) | <0.0001c | 1.31 (1.19‐1.43) | <0.0001c |
| <5 mg/w | 730 (25.2) | 1385 (24.0) | 1.17 (1.05‐1.30) | 0.0039c | 1.19 (1.07‐1.33) | 0.002c |
| 5 to <10 mg/w | 413 (14.3) | 640 (11.1) | 1.43 (1.25‐1.65) | <0.0001c | 1.46 (1.27‐1.67) | <0.0001c |
| ≥10 mg/w | 176 (6.1) | 253 (4.4) | 1.55 (1.26‐1.89) | <0.0001c | 1.57 (1.28‐1.92) | <0.0001c |
| P trend | <0.0001c | <0.0001c | ||||
| Hydroxychloroquine | 806 (27.9) | 1444 (25.0) | 1.16 (1.05‐1.28) | 0.0042c | 1.15 (1.04‐1.28) | 0.006c |
| Sulfasalazine | 1955 (67.6) | 3673 (63.6) | 1.19 (1.09‐1.31) | 0.0002c | 1.20 (1.09‐1.32) | 0.0002c |
| Leflunomide | 295 (10.2) | 481 (8.3) | 1.25 (1.07‐1.46) | 0.0041c | 1.26 (1.08‐1.46) | 0.003c |
| Cyclosporine | 375 (13.0) | 549 (9.5) | 1.42 (1.23‐1.63) | <0.0001c | 1.44 (1.25‐1.66) | <0.0001c |
| Corticosteroids (ref: Corticosteroid nonusers) | 2583 (89.3) | 4781 (82.8) | 1.74 (1.51‐1.99) | <0.0001c | 1.73 (1.51‐1.98) | <0.0001c |
| <5 mg/d | 1663 (57.5) | 3473 (60.1) | 1.54 (1.34‐1.77) | <0.0001c | 1.53 (1.33‐1.77) | <0.0001c |
| 5 to <10 mg/d | 798 (27.6) | 1131 (19.6) | 2.27 (1.94‐2.65) | <0.0001c | 2.26 (1.93‐2.65) | <0.0001c |
| ≥10 mg/d | 122 (4.2) | 177 (3.1) | 2.21 (1.70‐2.88) | <0.0001c | 2.19 (1.68‐2.85) | <0.0001c |
| P trend | <0.0001c | <0.0001c | ||||
| TNF antagonist (ref: TNF antagonist nonusers) | 255 (8.8) | 411 (7.1) | 1.26 (1.07‐1.49) | 0.0052c | 1.27 (1.08‐1.50) | 0.004c |
| Adalimumab | 82 (2.8) | 104 (1.8) | 1.59 (1.19‐2.13) | 0.0019c | 1.61 (1.20‐2.16) | 0.002c |
| Etanercept | 192 (6.6) | 335 (5.8) | 1.15 (0.96‐1.39) | 0.12 | 1.16 (0.97‐1.40) | 0.11 |
| Rituximab (ref: Rituximab nonusers) | 27 (0.9) | 27 (0.5) | 2.01 (1.17‐3.43) | 0.01c | 2.06 (1.21‐3.53) | 0.008c |
| Statins (ref: Statin nonusers) | 345 (11.9) | 665 (11.5) | 1.04 (0.91‐1.20) | 0.57 | 0.99 (0.85‐1.14) | 0.87 |
csDMARD indicates conventional synthetic disease‐modifying antirheumatic drug; HZ, herpes zoster; NSAID, nonsteroidal anti‐inflammatory drug; OR, odds ratio; RA, rheumatoid arthritis; TNF, tumor necrosis factor.
a
Adjusted for age, sex, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, diabetes mellitus, dyslipidemia, and hypertension.
b
Other immunosuppressive medications included were csDMARDs, corticosteroids, TNF antagonist, and rituximab.
c
A P‐value of <0.05 was indicated that medication use was associated with herpes zoster.