Psoriasis or other autoimmune conditions make it more dangerous if a person also gets shingles; it ups the chance of a stroke.
People who have autoimmune diseases, including psoriasis, who get incident herpes zoster have a 50 percent increased stroke risk within a month of developing shingles, according to a new study.
The frequency of herpes zoster, an opportunistic infection caused by varicella zoster virus, is increasing among patients on immunosuppressive therapies, including biologics.
Researchers from the Cleveland Clinic in Ohio, analyzed Medicare data from 2006 to 2012 to identify nearly 51,000 patients with incident herpes zoster and diagnoses of one of these autoimmune diseases: ankylosing spondylitis, inflammatory bowel disease, psoriasis, psoriatic arthritis or rheumatoid arthritis. They followed patients for ischemic stroke hospitalizations after shingles diagnoses, comparing one-, six- and 12-month follow ups.
Six months post herpes zoster diagnosis, the crude incidence rate of hospitalized ischemic stroke was 9.8 for each 1,000 patient years, compared to a rate of 8.7 per 1,000 in years two to six, according to the study. Among patients with more complicated herpes zoster, which represented two-thirds of the group, that hazard ratio for stroke was 3.2 in the first 30 days, compared to 1.6 in the uncomplicated group. Patients who were prescribed antivirals with seven days of their herpes zoster diagnoses had a 16 percent lower stroke risk than those who were not on antivirals, according to the study.