Rheumatology · 2 h ago
Taiwanese RA cohort finds lower herpes zoster incidence with tocilizumab
A propensity score–weighted analysis of Taiwan health insurance data compared safety outcomes in 1,074 patients with rheumatoid arthritis treated with tocilizumab or tofacitinib. Herpes zoster incidence was lower in the tocilizumab group; the study found no statistically significant differences in the other evaluated outcomes.
- Herpes zoster incidence was lower with tocilizumab.
- Rates were 3.125 versus 6.875 per 100 patient-years.
- Other evaluated safety outcomes showed no significant differences.
- Observational design and few events limit interpretation.
Researchers used Taiwan’s National Health Insurance Research Database to identify patients with rheumatoid arthritis treated with tocilizumab or tofacitinib between 2010 and 2018, with follow-up through 2020. Stabilized propensity score weighting was used to balance baseline characteristics. The analysis included 463 patients receiving tocilizumab and 611 receiving tofacitinib; mean follow-up was approximately two years in each group. Outcomes included mortality, cancer, cardiovascular events, venous thromboembolism, tuberculosis, joint replacement and herpes zoster.
Herpes zoster incidence was 3.125 per 100 patient-years with tocilizumab and 6.875 with tofacitinib. The hazard ratio for tocilizumab versus tofacitinib was 0.455 (95% CI 0.289–0.716; P=0.0007). The authors reported no statistically significant differences between groups for the other evaluated safety outcomes or mortality.
These real-world findings suggest a difference in herpes zoster incidence but do not establish that one treatment caused the difference. The observational design and relatively small number of events, which the authors say produced wide confidence intervals, limit interpretation of the other safety comparisons. The results alone do not establish a basis for changing treatment.
In practice
For people with rheumatoid arthritis receiving tocilizumab or tofacitinib, this Taiwanese claims-based cohort found a lower observed herpes zoster incidence with tocilizumab: 3.125 versus 6.875 cases per 100 patient-years. The propensity score–weighted observational comparison does not establish causality and, by itself, does not justify changing treatment. Other evaluated safety outcomes did not differ significantly, but the authors note that relatively few events led to wide confidence intervals. Applicability beyond this population and setting is uncertain.
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Clinical Rheumatology: Safety profiles of tocilizumab and tofacitinib in rheumatoid arthritis: a propensity score–weighted comparative analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.