Trivedi C, Shah Y, Khan N Slides compiled by Dr. Michael Stewart

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Safety of herpes zoster vaccination among IBD patients being treated with anti-TNF medications Trivedi C, Shah Y, Khan N Slides compiled by Dr. Michael Stewart UEGW 2017

Introduction Background and objectives Methods The risk of herpes zoster (HZ) is higher in patients treated with anti-TNF medications The herpes zoster vaccine (HZV) is a live vaccine and is not recommended for patients currently taking anti-TNF medications The goal of this study was to determine the safety of HZV while patients are on anti-TNF therapy Methods Retrospective cohort study of IBD patients followed between 2001 and 2016 from the Veterans Affairs (VA) healthcare system Pharmacy database used to determine anti-TNF exposure periods Patients with HZV administration while on anti-TNF were identified through vaccination codes; confirmed with chart review anti-TNF: anti-tumor necrosis factor

Results Demographics n (%) Age, years < 50 4 (6.8) 50–59 10 (17) 60–69 31 (52.5) 70–79 9 (15.2) ≥ 80 5 (8.5) Sex Male 51 (86.4) Female 8 (13.6) Race Caucasian 53 (89.8) African American 3 (5.1) Others 2 (3.4) Unknown 1 (1.7) Charlson comorbidity 0, 1 ≥ 2 56 (94.9) Type of IBD Crohn’s disease Ulcerative colitis 24 (40.7) Indeterminate colitis Results 56,417 IBD patients identified 59 on anti-TNF when HZV given; 13 (22%) taking a thiopurine Median time between last dose of IFX and HZV was 23 days (IQR 13.5–32.3); ADA was 8 days (IQR 4.8–10.3). Median age at the time of HZV was 64.9 years (IQR 60–69) No case of HZ related to HZV was found within 0–42 days of HZV administration Conclusions Administration of HZV to IBD patients taking anti-TNF appears safe in this small cohort of patients ADA: adalimumab; anti-TNF: anti-tumor necrosis factor; HZ: herpes zoster; HZV: herpes zoster vaccine; IBD: inflammatory bowel disease; IFX: infliximab