Use of medications known as monoclonal anti-tumor necrosis factor-alpha antibodies (infliximab, adalimumab) for the treatment of rheumatoid arthritis (RA) appear to be related to an increased risk of shingles (herpes zoster). According to a study in the February 18 issue of the Journal of the American Medical Association, German researchers investigated the association of various RA treatments, including adalimumab or infliximab, etanercept (a fusion protein), and disease-modifying anti-rheumatic drugs (DMARDs) in 5,040 RA patients. Although there was no appreciable difference between shingles and treatment with etanercept or anti-TNF-alpha treatment as a class, there was a significant association (45 percent) in patients treated with infliximab and adalimumab. An even higher risk of shingles was found for older patients and for those treated with glucocorticoids (steroids used as anti-inflammatory medications).
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