FRI0117 INCIDENCE RATE OF HERPES ZOSTER IN RHEUMATOID ARTHRITIS PATIENTS UNDER TOFACITINIB: REAL LIFE DATA FROM TURKEY HURBIO REGISTRY
Background: Tofacitinib (TOF) is an orally administered Janus Kinase (JAK) inhibitor and is commonly used in rheumatoid arthritis. There is a heterogeneity among numbers reported from different continents about herpes zoster (HZ) incidence rate (1 3) However, data about HZ risk in our country, which stands like a bridge between Asia and Europe, is lacking. Objectives: To assess the real life incidence of herpes zoster in RA patients under tofacitinib. Methods: We analyzed all patients who had at least 1 control visit under tofacitinib and registered to HURBIO database. We calculated incidence rate by dividing the number of patients with herpes zoster to total follow up years, then multiplied by 100 (per 100 patient years) Results: A total of 204 (174 (85.4% female) patients were recruited. Mean age was 53.2+ 12.5 years. Mean disease duration was 11.5+ 8.1 years. Rheumatoid factor and anti CCP antibodies were positive in 135/198 (68.1 and 115/171 (67.2 patients, respectively. Median follow up while receiving TOF was 11.6 (IQR:5.2 26.2) months. Combination with DMARDs was used in 83.3% of patients. 55.5% of patients was biologic naive. Eleven (5.3% incidence rate: 3.9 (2.3 8.5; 95 CI) per 100 patient years) patients had zona zoster. Ten of these patients was female, median age was 59 (IQR; 52 69) and 4 of them was older than 65 years old. Rheumatoid factor was positive in 9 patients. Only 1 of these patients had diabetes. Median follow up of these patients under TOF was 8.1(IQR: 6 25) months. Ten of these patients had concomitant DMARDs (9 hydroxycholoroquine, 4 methotrexate, 2 leflunomide; according to last follow up visit) and 9 of them received concomitant steroids (med(IQR) 4 (1 8) mg at equivalant methyl prednisolon dose) Eight of them was biologic naive. Tofacitinib was discontinued in 4 of these patients. Conclusion: In this real life data from Turkey, we found a HZ incidence rate similar to that reported from USA and global data; however, we found a lower incidence rate that reported from Japan (Figure 1).Figure 1. Reported herpes zoster incidence rates across different countries (numbers in paranthesis indicate reference number) References: [1]Winthrop KL, Curtis JR, Lindsey S, Tanaka Y, Yamaoka K, Valdez H, et al. Herpes Zoster and Tofacitinib: Clinical Outcomes and the Risk of Concomitant Therapy. Arthritis rheumatology (Hoboken, NJ) 2017;69(10):1960 8. [2]Curtis JR, Xie F, Yun H, Bernatsky S, Winthrop KL. Real world comparative risks of herpes virus infections in tofacitinib and biologic treated patients with rheumatoid arthritis. Ann Rheum Dis. 2016;75(10):1843 7. [3]Yamanaka H, Tanaka Y, Takeuchi T, Sugiyama N, Yuasa H, Toyoizumi S, et al. Tofacitinib, an oral Janus kinase inhibitor, as monotherapy or with background methotrexate, in Japanese patients with rheumatoid arthritis: an open label, long term extension study. Arthritis Res Ther. 2016;18:34. Disclosure of Interests: Emre Bilgin: None declared, Furkan Ceylan: None declared, Emine Duran: None declared, Ertugrul Cagri Bolek: None declared, Bayram Farisogullari: None declared, Gozde Kubra Yardimci: None declared, Levent Kilic: None declared, Ali Akdogan: None declared, Omer Karadag: None declared, Sule Apras Bilgen: None declared, Sedat Kiraz: None declared, Ali Ihsan Ertenli: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB