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Humira, Kineret, Remicade May Raise the Risk of Developing Shingles

Feb 18, 2009 | Parker Waichman Alonso LLP

Shingles seems to be one of the adverse reactions to rheumatoid arthritis sufferers taking Humira, Kineret, and Remicade.  WebMD Health News reported that these drugs, in the TNF-alpha blocker class, nearly doubled the risk of shingles—herpes zoster—in a German study involving 5,040 patient participants.

Humira, Kineret, and Remicade each increased the risk of developing shingles by 80 percent according to Anja Strangfeld, MD from the German Rheumatism Research Center in Berlin, "We compared these different types of TNF inhibitor with conventional disease-modifying anti-rheumatic drugs and we found there is an increased risk of herpes zoster in patients treated with the monoclonal antibodies."  The drugs are also used in the treatment of ankylosing spondylitis, psoriatic arthritis, and Crohn’s  disease because they quiet unmanageable immune responses common with these diseases, said Web MD.

The Guardian explained that rheumatoid arthritis occurs when the body’s immune system attacks joint linings, causing stiffness, swelling, and pain.  Shingles occurs when the herpes zoster virus—the virus that causes chickenpox—is activated in people who have already suffered from chickenpox.  Shingles cause severely painful blisters, headache, flu-like symptoms without fever, itching, tingling, pain, dizziness, weakness, vision changes, and changes in thought processes

Unfortunately, said Richard J. Whitley, MD, professor of pediatrics, microbiology, medicine, and neurosurgery at the University of Alabama, Birmingham, the drugs can not only prompt shingles in patients taking Humira, Kineret, and Remicade, the risk increases in those patients who have already suffered from shingles, reported Web MD.  "It's pretty clear that if you have had previous zoster and take these anti-TNF monoclonal antibodies, you are going to reactivate it," Whitley told WebMD.

About one in five—or 25 percent—of the participants who developed shingles also suffered complications, which was more than expected, said Robert F. Betts, MD, professor of medicine at the University of Rochester, New York, according to WebMD.  The risk of shingles appeared to be highest in older patients and those also taking steroids, said HealthDay News.  And while a vaccine for shingles exists, it cannot be administered when anti-TNF drugs—which are immune system suppressants—are being taken as the shingles medication contains a live virus.

HealthDay News reported that severe cases of shingles—a viral infection—have been reported in patients being treated with TNF blockers and that there is an established link between the medications and fungal and bacterial infections.  As a matter-of-fact, late last year, the U.S. Food and Drug Administration (FDA), urged the makers of Humira, Cimzia, Enbrel, and Remicade to increase safety warnings regarding the risk of developing opportunistic fungal infections; all of the medications carried black-box warnings concerning other safety issues, said HealthDay News.

The study was conducted at the German Rheumatism Research Centre in Berlin, Germany and its findings appear in today’s issue of the Journal of the American Medical Association, said the Guardian.