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Crohn's Disease Forum » Treatment » Humira/Adalimumab » Can't Get Shingles Shot


08-01-2016, 05:30 PM   #1
JackG
 
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Can't Get Shingles Shot

I have been meaning to ask the group if anyone has any information or experience with Shingles and Crohns. I was refused the Shingles vaccine at Walgreens because it's a live virus that you're injected with, and Humira makes it harder for us to defend ourselves. Do we therefor have a greater incidence of Shingles?
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Diagnosed 1982
Ileostomy and reconnect
Meds over the years: Sulfasalazine, Pentasa, Prednisone, Entocort, Azathioprine (allergic reaction)
Present: Humira
08-01-2016, 05:48 PM   #2
my little penguin
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Abstract
Background

Patients with inflammatory bowel disease (IBD) on certain immunosuppressants have increased herpes zoster (HZ) risk.

Aim

To determine the risk of HZ in IBD and how anti-tumor necrosis factor-alpha (anti-TNF)agents affect this risk.

Methods

We performed a retrospective cohort and nested case-control study using administrative data from IMS LifeLink® Information Assets-Health Plan Claims Database. In the cohort, we identified IBD patients < age 64 by diagnosis codes; matched to 4 individuals without IBD. HZ risk was evaluated by incidence rate ratio (IRR) and adjusted Cox proportional hazards models (HR). In the nested case-control analysis, 2,659 IBD patients with HZ were each matched to 4 IBD patients without HZ. We determined associations between medications and HZ using conditional logistic regression.

Results

The cohort included 50,932 patients with Crohn’s disease (CD), 56,403 patients with ulcerative colitis (UC), and 1,269 with unspecified IBD, matched to 434,416 individuals without IBD. The IBD cohort had increased HZ risk compared to non-IBD (IRR 1.68, 95% CI 1.60-1.76). After adjustment, IBD patients had a higher risk of HZ than non-IBD (HR 1.49, 95% CI 1.42-1.57). In the nested case-control multivariate adjusted analyses, anti-TNF medications (OR 1.81, 95% CI 1.48-2.21), corticosteroids (OR 1.73, 95% CI 1.51-1.99) and thiopurines (OR 1.85, 95% CI 1.61-2.13) were independently associated with HZ. Risk of HZ was highest with combination anti-TNF and thiopurine therapy (OR 3.29, 95% CI 2.33-4.65).

Conclusions

Patients with IBD are at increased risk for HZ. Use of thiopurines, anti-TNF agents, combination therapy, and corticosteroids increases HZ risk.

From
http://www.ncbi.nlm.nih.gov/pmc/arti...report=classic
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08-01-2016, 06:24 PM   #3
JackG
 
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Thanks, Penguin; does this suggest problems with IBD and Crohn's generally because of weakened immunity? And in particular would that apply especially to Shingles, with the commercials suggesting one in three will get it?
08-02-2016, 05:20 AM   #4
my little penguin
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No idea
I can say my DH had shingles - young no immunosupression no Ibd
Ds was exposed while on immunosuppressants/biologics no issues
You can't get shingles unless you have had chicken pox
And big and here
The virus is laying dormant in your system from the previous chicken pox
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