本研究旨在评估接受托法替布 (TOFA) 治疗的类风湿性关节炎 (RA) 患者发生带状疱疹 (HZ) 的危险因素。这项回顾性研究回顾了接受 TOFA 治疗的 RA 患者。我们比较了最近接受和未接受生物合成缓解病情抗风湿药物 (bDMARD) 治疗的患者的临床特征、实验室概况、伴随用药和带状疱疹发生率，bDMARD 的定义是在开始 TOFA 之前 ≤ 180 天给药治疗。我们使用单变量 Cox 比例风险模型和 Kaplan-Meier 分析来评估危险因素。在 304 名 RA 患者中，97 名近期使用过 bDMARD，207 名没有使用。最近使用 bDMARD 的患者通常每周服用的甲氨蝶呤剂量较低，羟氯喹的使用较少，且随访时间较短。在最近的bDMARDs组中，64例（66.0%）使用肿瘤坏死因子抑制剂（TNFi），19例（19.6%）使用托珠单抗，14例（14.4%）使用阿巴西普。带状疱疹的总体发病率 (IR) 为每 100 人年 5.62 例。与近期未使用 bDMARD 的患者相比，近期使用 bDMARD 的患者表现出更高的 HZ 风险（IR 比：2.34，95% 置信区间 [CI]：1.04-5.19，p = 0.028）。在多变量分析中，最近使用 bDMARD（风险比：2.4，95% CI：1.12-4.95，p = 0.024）是带状疱疹的独立危险因素。 Kaplan-Meier 分析证实，近期使用 bDMARD 且接受 TOFA 治疗的 RA 患者的 HZ 风险增加（对数秩 p = 0.015）。HZ 在接受 TOFA 治疗的 RA 患者中很常见，近期使用 bDMARD（TNFi、托珠单抗和阿巴西普）存在风险。 HZ 因子。因此，应建议该人群接种带状疱疹疫苗。版权所有 © 2024，中华医学会。

This study sought to assess the risk factors of herpes zoster (HZ) in rheumatoid arthritis (RA) patients treated with tofacitinib (TOFA).This retrospective study reviewed RA patients receiving TOFA. We compared clinical characteristics, laboratory profiles, concomitant medication use, and HZ incidence in patients with and without recent biologic synthetic disease-modifying anti-rheumatic drugs (bDMARDs) treatment, which is defined as their administration ≤ 180 days prior to the initiation of TOFA treatment. We used univariate Cox proportional hazards models and Kaplan-Meier analysis to assess risk factors.Among 304 RA patients, 97 had recent bDMARDs use and 207 did not. Patients with recent bDMARDs use typically had lower weekly doses of methotrexate, less hydroxychloroquine use, and shorter follow-up times. In the recent bDMARDs group, 64 (66.0%) used tumor necrosis factor inhibitors (TNFi), 19 (19.6%) used tocilizumab, and 14 (14.4%) used abatacept. The overall incidence rate (IR) of HZ was 5.62 per 100 person-years. Patients with recent bDMARDs use exhibited a higher HZ risk compared to those without recent bDMARDs use (IR ratio: 2.34, 95% confidence interval [CI]: 1.04-5.19, p = 0.028). Recent bDMARDs use (hazard ratio: 2.4, 95% CI: 1.12-4.95, p = 0.024) was an independent risk factor for HZ among multivariable analysis. Kaplan-Meier analysis confirmed increased HZ risk in RA patients on TOFA with recent bDMARDs use (log-rank p = 0.015).HZ is common in RA patients treated with TOFA, and recent bDMARDs (TNFi, tocilizumab and abatacept) use is a risk factor of HZ. HZ vaccination, therefore, should be recommended for this group.Copyright © 2024, the Chinese Medical Association.