The herpes zoster vaccine may be safe to use in psoriasis patients, including those who currently take biologic drugs or other immunomodulators after all, a new study shows.
As it stands, the FDA states that this live vaccine is contraindicated among patients receiving some immunosuppressive medications commonly used to treat psoriasis and other inflammatory diseases. This includes all immune-modulating biologic agents and some non-biologic immunosuppressive medications.
The new analysis of nearly 20,000 vaccinated Medicare beneficiaries found that the live herpes zoster vaccine is not associated with an increased risk of shingles shortly after vaccination in patients currently treated with biologics, and that it is associated with a significantly reduced longer-term risk of herpes zoster in patients with an immune-mediated disease. The findings appear in the July 4, 2012, issue of The Journal of the American Medical Association.
Of 633 patients exposed to biologics, including 551 patients exposed to anti-tumor necrosis factor biologics, no cases of varicella or herpes zoster occurred within the 42 days following vaccination.
During the period of more than 42 days after vaccination, the researchers observed 138 herpes zoster cases. After controlling for demographics, type of immune-mediated disease, health care utilization, and exposure to biologic and nonbiologic disease-modifying antirheumatic drugs and oral glucocorticoids, data indicated that vaccination was associated with decreased herpes zoster risk over a median of 2 years of follow-up.
“Our data call into question the current recommendations that herpes zoster vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of HZ vaccination among patients receiving biologics,” the authors conclude.