A randomized controlled trial found that the live shingles, or varicella-zoster, vaccine was safe and showed short-term efficacy for participants also taking tumor necrosis factor inhibitors (TNFis) for a broad range of inflammatory disorders. These finding suggest that a live virus vaccine in immunosuppressed patients receiving biologic therapies may be a reasonable option, especially for the zoster vaccine, if no alternative vaccine is available. The findings are published in Annals of Internal Medicine.
TNFis are increasingly used in the United States and worldwide to treat a range of chronic autoimmune and inflammatory diseases, including rheumatoid arthritis, psoriasis, and inflammatory bowel diseases, but their use may result in immunosuppression. Compared with the general population, patients with these conditions are at higher risk for varicella-zoster virus reactivation, or shingles, due to their underlying disease states and commonly used immunosuppressive treatments, such as glucocorticoids. The safety and effectiveness of live virus vaccines largely are unknown in this patient population.
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