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. 2023 Jan 13;43(3):421–435. doi: 10.1007/s00296-022-05270-6

Table 2.

Studies included in this SLR that examined the role of concomitant glucocorticoids on the risk of HZ development in JAKi-treated patients

Author, year (ref), country Study type follow-up Disease JAKi Age, yearsa Key findings RoB
Curtis 2019 [41] US Cohort NR RA TOFA 60.3 (12.6) IR (95% CI)* HR (95% CI) Low
TOFA monotherapy 3.7 (2.9–4.6) 1.0 (ref)
TOFA + MTX 3.4 (2.3–5.0) 0.99 (0.64–1.54)
TOFA + GCs 6.0 (4.9–7.5) 1.75 (1.28–2.41)
TOFA + MTX + GCs 6.5 (4.8–8.8) 1.96 (1.33–2.88)
Guidelli 2021 [67] Italy Prospective cohort  ≤ 48 weeks RA BARI  59.0 (11.9)  In BARI-treated patients on GCs, the rate of VZV reactivation was significantly higher compared to other infections (83% vs. 25%; p = 0.034) Intermediate
Redeker 2022 [101] Germany Prospective cohort  ≤ 480 weeks RA TOFA, BARI or UPA 57.9 (12.5)

Among JAKi-treated patients, the ER of HZ was comparable between those with and those without concomitant GC use

Dose-dependent relationship; HR (95% CI):

GCs 5–10 vs. 0 mg/day: 1.24 (0.98 to 1.57)

GCs > 10 vs. 0 mg/day: 3.45 (2.14 to 5.55)

Intermediate

aMean/median (SD/IQR)

*Per 100 patient-years

ref reference, NR not reported, ER event rate, IR incidence rate, HR hazard ratio, CI confidence interval, JAKi Janus kinases inhibitor, TOFA tofacitinib, BARI baricitinib, UPA upadacitinib, RoB risk of bias, VZV varicella zoster virus, GCs glucocorticoids