TNF inhibitors and shingles

 

Question  I have had RA for 16 years and am currently on Enbrel and imuron. This week I have been diagnosed with shingles and a urinary tract infection. Could this be a result of my weakened immune system and should I stop the Enbrel?
 
Answer  Yes, Enbrel and Imuran do increase your chances of infection such as shingles (Herpes zoster) and urinary tract infections.  But these infections  might also occur without these medications.  Other medications to treat RA such as methotrexate and prednisone also may increase the risk of shingles.   Thus in general although we may hold the medications during the active infections we do not stop them permanently.  Particularly in the elderly population, consideration should be given to administering the shingles vaccine prior to starting a TNF inhibitor

Last update: 12:07 PM Saturday, June 13, 2009

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Alan Matsumoto, MD

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