Increased risk of herpes zoster in patients with psoriasis: A population-based retrospective cohort study

Shin Yi Tsai, Hsuan Ju Chen, Chon Fu Lio, Hui Ping Ho, Chien Feng Kuo, Xiaofeng Jia, Chi Chen, Yu Tien Chen, Yi Ting Chou, Tse Yen Yang, Fang Ju Sun, Leiyu Shi

Research output: Contribution to journalArticle

Abstract

Objectives: The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. Methods: We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. Results: The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07–1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15–2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04–1.79), study participants in the age group of 20–39 years (adjusted HR, 1.77; 95% CI, 1.17–2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02–1.84). Conclusions: Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.

Original languageEnglish (US)
Article numbere0179447
JournalPLoS One
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2017

Fingerprint

psoriasis
Herpes Zoster
cohort studies
Psoriasis
Hazards
Cohort Studies
Retrospective Studies
Population
confidence interval
Confidence Intervals
Health insurance
therapeutics
Intrinsic Factor
Regression analysis
health insurance
National Health Programs
Therapeutics
Taiwan
Proportional Hazards Models
gender differences

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Increased risk of herpes zoster in patients with psoriasis : A population-based retrospective cohort study. / Tsai, Shin Yi; Chen, Hsuan Ju; Lio, Chon Fu; Ho, Hui Ping; Kuo, Chien Feng; Jia, Xiaofeng; Chen, Chi; Chen, Yu Tien; Chou, Yi Ting; Yang, Tse Yen; Sun, Fang Ju; Shi, Leiyu.

In: PLoS One, Vol. 12, No. 8, e0179447, 01.08.2017.

Research output: Contribution to journalArticle

Tsai, SY, Chen, HJ, Lio, CF, Ho, HP, Kuo, CF, Jia, X, Chen, C, Chen, YT, Chou, YT, Yang, TY, Sun, FJ & Shi, L 2017, 'Increased risk of herpes zoster in patients with psoriasis: A population-based retrospective cohort study', PLoS One, vol. 12, no. 8, e0179447. https://doi.org/10.1371/journal.pone.0179447
Tsai, Shin Yi ; Chen, Hsuan Ju ; Lio, Chon Fu ; Ho, Hui Ping ; Kuo, Chien Feng ; Jia, Xiaofeng ; Chen, Chi ; Chen, Yu Tien ; Chou, Yi Ting ; Yang, Tse Yen ; Sun, Fang Ju ; Shi, Leiyu. / Increased risk of herpes zoster in patients with psoriasis : A population-based retrospective cohort study. In: PLoS One. 2017 ; Vol. 12, No. 8.
@article{b62b460a081043f59d9fab581720f918,
title = "Increased risk of herpes zoster in patients with psoriasis: A population-based retrospective cohort study",
abstract = "Objectives: The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. Methods: We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. Results: The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95{\%} confidence interval (CI) = 1.07–1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95{\%} confidence interval [CI], 1.15–2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95{\%} CI, 1.04–1.79), study participants in the age group of 20–39 years (adjusted HR, 1.77; 95{\%} CI, 1.17–2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95{\%} CI, 1.02–1.84). Conclusions: Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.",
author = "Tsai, {Shin Yi} and Chen, {Hsuan Ju} and Lio, {Chon Fu} and Ho, {Hui Ping} and Kuo, {Chien Feng} and Xiaofeng Jia and Chi Chen and Chen, {Yu Tien} and Chou, {Yi Ting} and Yang, {Tse Yen} and Sun, {Fang Ju} and Leiyu Shi",
year = "2017",
month = "8",
day = "1",
doi = "10.1371/journal.pone.0179447",
language = "English (US)",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

TY - JOUR

T1 - Increased risk of herpes zoster in patients with psoriasis

T2 - A population-based retrospective cohort study

AU - Tsai, Shin Yi

AU - Chen, Hsuan Ju

AU - Lio, Chon Fu

AU - Ho, Hui Ping

AU - Kuo, Chien Feng

AU - Jia, Xiaofeng

AU - Chen, Chi

AU - Chen, Yu Tien

AU - Chou, Yi Ting

AU - Yang, Tse Yen

AU - Sun, Fang Ju

AU - Shi, Leiyu

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objectives: The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. Methods: We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. Results: The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07–1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15–2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04–1.79), study participants in the age group of 20–39 years (adjusted HR, 1.77; 95% CI, 1.17–2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02–1.84). Conclusions: Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.

AB - Objectives: The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. Methods: We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. Results: The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07–1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15–2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04–1.79), study participants in the age group of 20–39 years (adjusted HR, 1.77; 95% CI, 1.17–2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02–1.84). Conclusions: Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.

UR - http://www.scopus.com/inward/record.url?scp=85027863515&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027863515&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0179447

DO - 10.1371/journal.pone.0179447

M3 - Article

C2 - 28829784

AN - SCOPUS:85027863515

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 8

M1 - e0179447

ER -