Table 3.
Incidence Rates (IR) and Incidence Rate Ratios (IRR) for Treated Herpes Zoster by Exposure in Patients with Psoriasis or PsA
| Exposure at Index Date | Cases | Person-Years | IR per 1000 PY (95% CI) | Crude IRR (95% CI) | Adjusted IRR (95% CI) * |
|---|---|---|---|---|---|
| All Patients | N=2271 | Total=255,451 | 8.9 (8.5–9.3) | – | – |
| DMARDs only | 256 | 25,865 | 9.9 (8.7–11.2) | Reference | Reference |
| Apremilast | 120 | 17,180 | 7.0 (5.8–8.4) | 0.71 (0.57–0.88) | 0.75 (0.60–0.94) |
| Apremilast only | 82 | 12,842 | 6.4 (5.1–7.9) | 0.65 (0.50–0.83) | 0.70 (0.54–0.90) |
| Apremilast + other | 38 | 4338 | 8.8 (6.2–12.0) | 0.89 (0.63–1.24) | 0.89 (0.63–1.25) |
| TNF-i biologics only | 712 | 75,547 | 9.4 (8.7–10.1) | 0.95 (0.83–1.10) | 1.11 (0.96–1.28) |
| IL-i biologics only | 173 | 25,654 | 6.7 (5.8–7.8) | 0.68 (0.56–0.83) | 0.82 (0.68–1.00) |
| CS only | 169 | 13,943 | 12.5 (10.4–14.1) | 1.22 (1.01–1.49) | 1.22 (1.01–1.49) |
| DMARDs + CS | 75 | 5990 | 12.5 (9.8–15.7) | 1.27 (0.98–1.64) | 1.19 (0.92–1.54) |
| TNF-i with DMARDs and/or CS | 284 | 23,806 | 11.9 (10.6–13.4) | 1.21 (1.02–1.43) | 1.23 (1.04–1.46) |
| IL-i with DMARDs and/or CS | 49 | 4742 | 10.3 (7.6–13.7) | 1.04 (0.77–1.42) | 1.12 (0.82–1.52) |
| Unexposed | 433 | 62,723 | 6.9 (6.3–7.6) | 0.70 (0.60–0.81) | 0.77 (0.66–0.90) |
| All patients with PsA | N=1268 | Total=132,721 | 9.6 (9.0–10.1) | – | – |
| DMARDs only | 141 | 14,154 | 10.0 (8.4–11.7) | Reference | Reference |
| Apremilast | 67 | 7,367 | 9.1 (7.0–11.5) | 0.91 (0.68–1.22) | 0.95 (0.71–1.28) |
| Apremilast only | 37 | 4515 | 8.2 (5.8–11.3) | 0.82 (0.57–1.18) | 0.87 (0.61–1.25) |
| Apremilast + other | 30 | 2852 | 10.5 (7.1–15.0) | 1.06 (0.71–1.20) | 1.08 (0.73–1.60) |
| TNF-i biologics only | 392 | 39,734 | 9.9 (8.9–10.9) | 0.99 (0.82–1.20) | 1.13 (0.93–1.38) |
| IL-i biologics only | 59 | 8068 | 7.3 (5.6–9.4) | 0.73 (0.54–0.99) | 0.86 (0.63–1.16) |
| CS only | 102 | 8349 | 12.2 (10.0–14.8) | 1.23 (0.95–1.58) | 1.22 (0.94–1.57) |
| DMARDs + CS | 44 | 3668 | 12.0 (8.7–16.1) | 1.20 (0.86–1.69) | 1.15 (0.82–1.62) |
| TNF-i with DMARDs and/or CS | 220 | 18,477 | 11.9 (10.4–13.6) | 1.20 (0.97–1.48) | 1.24 (1.00–1.53) |
| IL-i with DMARDs and/or CS | 32 | 2793 | 11.5 (7.8–16.2) | 1.15 (0.78–1.69) | 1.23 (0.84–1.82) |
| Unexposed | 211 | 30,111 | 7.0 (6.1–8.0) | 0.70 (0.57–0.87) | 0.75 (0.60–0.93) |
| All patients with psoriasis only | N=1003 | Total=122,730 | 8.2 (7.7–8.7) | – | – |
| DMARDs only | 115 | 11,711 | 9.8 (8.1–11.8) | Reference | Reference |
| Apremilast | 53 | 9813 | 5.4 (4.0–7.1) | 0.55 (0.40–0.76) | 0.59 (0.42–0.82) |
| Apremilast only | 45 | 8327 | 5.4 (3.9–7.2) | 0.55 (0.40–0.78) | 0.59 (0.42–0.84) |
| Apremilast + other | 8 | 1486 | 5.4 (2.3–10.6) | 0.55 (0.27–1.12) | 0.56 (0.27–1.15) |
| TNF-i biologics only | 320 | 35,813 | 8.9 (8.0–10.0) | 0.91 (0.74–1.13) | 1.09 (0.88–1.36) |
| IL-i biologics only | 114 | 17,587 | 6.5 (5.3–7.8) | 0.66 (0.51–0.86) | 0.80 (0.61–1.68) |
| CS only | 67 | 5594 | 12.0 (9.3–15.2) | 1.22 (0.90–1.65) | 1.24 (0.84–1.85) |
| DMARDs + CS | 31 | 2322 | 13.4 (9.1–19.0) | 1.36 (0.91–2.02) | 1.24 (0.84–1.85) |
| TNF-i with DMARDs and/or CS | 64 | 5330 | 12.0 (9.2–15.3) | 1.22 (0.90–1.66) | 1.30 (0.96–1.77) |
| IL-i with DMARDs and/or CS | 17 | 1950 | 8.7 (5.1–14.0) | 0.89 (0.53–1.48) | 0.97 (0.58–1.61) |
| Unexposed | 222 | 32,612 | 6.8 (5.9–7.8) | 0.69 (0.55–0.87) | 0.78 (0.62–0.98) |
Note: *Adjusted for sex, age, calendar year, and rheumatoid arthritis.
Abbreviations: CI, confidence interval; CS, corticosteroids; DMARDs, disease-modifying antirheumatic drugs; IL-I, interleukin-17, −23 or −12/23 inhibitor biologics; IR, incidence rate; IRR, incidence rate ratio; PY, person-years; TNF-I, tumor necrosis factor inhibitor biologics.