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Researchers have discovered that a vaccine for shingles should be given to arthritis patients before they take drugs for the joint condition.

This is because sufferers are at a higher risk of developing shingles than other adults.

Furthermore, taking common arthritis drugs - such as tofacitinib and other antirheumatic drugs - can further increase this risk.

The results of two studies, published in the journal Arthritis & Rheumatology, found that the live varicella-zoster vaccine given to protect against shingles can induce an effective immune response in those suffering rheumatoid arthritis.

Researchers gave patients the vaccine several weeks before they started treatment with tofacitinib.

In one of the studies, 112 patients with rheumatoid arthritis were vaccinated and then split into two groups.

One group was given tofacitinib, and the other group received a placebo.

The vaccine triggered a robust immune response in all patients.

In those who received tofacitinib after vaccination there was no negative impact.

Whats more, patients treated with tofacitinib had a similar or even higher immune responses to the vaccine compared with patients given a placebo.

"We showed that the vaccine was adequately immunogenic in patients whether they were starting tofacitinib or placebo in a few weeks, and the immunogenicity and the response to the vaccine were similar to what we've seen outside the rheumatoid arthritis setting in general population studies," said Dr Kevin Winthrop, of Oregon Health and Science University.

However, the researchers also discovered that the vaccine should no be given to patients who have not had the chicken pox in the past.

In the second study, researchers looked to see if conventional synthetic disease-modifying antirheumatic drugs - such as csDMARDs, including methotrexate and chloroquine - or corticosteroids contributed to the increased risk of shingles linked to tofacitinib.

Research involved looking at 6192 patients with rheumatoid arthritis across 19 clinical trials.

They found shingles rates were lowest for patients taking tofacitinib without csDMARDs or corticosteroids and highest for those taking tofacitinib with csDMARDs and corticosteroids.

"If you want to lower shingles risk for rheumatoid arthritis patients, there are two strategies: one is vaccinating them and the other is getting them off steroids and methotrexate if you can," said Dr Winthrop.

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Rheumatoid arthritis treatment: Shingles vaccine should be given to ... - Express.co.uk

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