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Su W, Liu D, Yang P, Ye L. Opioids Prescribing Among Patients with Zoster-Related Pain in Real-Life: A Retrospective, Cohort Study Based on the Clinical Database. J Pain Res 2023; 16:3785-3796. [PMID: 38026468 PMCID: PMC10640811 DOI: 10.2147/jpr.s430439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The aim of this study was to analysis of the opioid use of opioid native zoster-related pain (ZRP) patients to evaluate the impact of opioid use on pain control and quality of life improvement based on the clinical database. Patients and Methods We conducted a retrospective cohort study to identify opioid native patients who were hospitalized in the pain department between May 1, 2020, and May 1, 2021. The primary outcomes were persistent opioid use after discharge, visual analogue scale (VAS) at the admission, VAS remission rate during hospitalization, VAS score and quality of life at follow-up. Then, we assessed patient-level risk factors for persistent opioid use after the discharge. Results A total of 350 patients met the inclusion criteria. Of those patients, 255 (72.9%) were administered with opioid during hospitalization, and 95 (27.1%) patients were not. Opioid prescription during hospitalization was independently associated with increased odds of persistent use after the discharge (adjusted odds ratio, 20.74; 95% CI, 4.504-95.474; P < 0.01). In the two groups, the VAS score at admission and the VAS score at follow-up were different. In the group with opioids during hospitalization, the persistent opioid use after discharge was more common (38% vs 2.1%) compared to patients without opioids, and VAS remission rate during hospitalization was less, restrictions on daily life, work or housework, and social activities were more common, and mood, diet and sleep were worse, respectively. Conclusion Opioids prescription during hospitalization might increase the risk of chronic opioid use in opioid native ZRP patients, and it has limited benefits in pain control and quality of life improvement. Even though PHN was painful and intractable, the use of opioids should also be more cautious, and strict follow-up, management in this population.
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Affiliation(s)
- Wei Su
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
- Department of Pain Management, Chengdu Second People's Hospital, Chengdu, Sichuan, 610011, People's Republic of China
| | - Dong Liu
- Department of Pain Management, Chengdu Second People's Hospital, Chengdu, Sichuan, 610011, People's Republic of China
| | - Pingliang Yang
- Department of Anesthesiology, the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, 610500, People's Republic of China
| | - Ling Ye
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
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Wen SY, Ou-Yang C, Chang C, Chen CC, Chang HY. Impact of Type 1 Versus Type 2 Diabetes on Developing Herpes Zoster and Post-herpetic Neuralgia: A Population-based Cohort Study. Acta Derm Venereol 2023; 103:adv9400. [PMID: 37787418 PMCID: PMC10561104 DOI: 10.2340/actadv.v103.9400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/14/2023] [Indexed: 10/04/2023] Open
Abstract
Type 2 diabetes is associated with an increased risk of herpes zoster and postherpetic neuralgia. However, the association of type 1 diabetes with herpes zoster or postherpetic neuralgia remains unclear. This retrospective cohort study using Taiwan's Health Insurance Research Database included 199,566 patients with type 1 diabetes and 1,458,331 with type 2 diabetes, identified during the period 2000 to 2012. Patients with type 1 diabetes had a significantly higher risk of developing herpes zoster than those with type 2 diabetes (p < 0.001). Across all age groups, the impact of diabetes on herpes zoster was greater in type 1 than in type 2 diabetes. Patients with both type 1 and type 2 diabetes had a 1.45-fold higher risk of post-herpetic neuralgia than those without diabetes (hazard ratio 1.45, 95% confidence interval 1.28-1.65; hazard ratio 1.45, 95% confidence interval 1.37-1.52, respectively), and there was no difference between the 2 types of diabetes (hazard ratio 1.06; 95% confidence interval 0.93-1.21). The results recommend consideration of herpes zoster vaccination at an earlier age in patients with type 1 diabetes.
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Affiliation(s)
- Su-Ying Wen
- School of Management, National Taiwan University of Science and Technology, Taipei, Taiwan; Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Science, Taipei, Taiwan; Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Health and Welfare, University of Taipei, Taipei, Taiwan,
| | - Chao Ou-Yang
- Department of Industrial Management, National Taiwan University of Science and Technology, Taipei 106, Taiwan
| | | | - Chu-Chieh Chen
- National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Hung-Yu Chang
- Division of Endocricrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; Health Care Center, Chang Gung Memorial Hospital, Taoyuan Branch, Taiwan.
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Ma Y, Li B, Sun L, He X, Wu S, Shi F, Niu L. A prospective randomized comparison of the efficacy of standard antiviral therapy versus ultrasound-guided thoracic paravertebral block for acute herpes zoster. Ann Med 2022; 54:369-378. [PMID: 35107389 PMCID: PMC8815626 DOI: 10.1080/07853890.2022.2031267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of repetitive thoracic paravertebral block (TPVB) under ultrasound (US) guidance for acute pain associated to herpes zoster (HZ) and its prophylactic effects on post-herpetic neuralgia (PHN). METHODS Patients who suffered from acute pain associated to HZ within 1 week of rash onset were randomized in a ratio of 1:1 to receive a seven-day course antiviral therapy, antiviral therapy with additional US-guided repetitive TPVB using transverse short axial (TSA) approach every 48 h for a week after antiviral therapy. All patients were allowed to receive rescue analgesics. The primary endpoint was HZ burden of illness (HZ-BOI) measured by a severity-by-duration composite pain assessment conducted 1-month post inclusion. Adverse events were also recorded. RESULTS A total of 96 patients completed the entire 6-month follow-up. The BOI-30AUC was 112.5 (95%CI: 105.2, 119.9) in control group, and 82.7 (95%CI: 75.4, 90.1) in TPVB group (F = 32.252, p<.001) at D30 after inclusion. Compared with control group, significant reductions of BOI-30-90AUC, and BOI-90-180AUC were observed in TPVB group (F = 11.392, p=.001 at D90; F = 7.467, p=.007 at D180, respectively). At 3 and 6 months after inclusion, the incidence of PHN in TPVB group was significantly lower than control group. Quality of life (QoL) in TPVB group also showed greater improvements at all the time points in all domains of EQ-5D-3L (p<.05). No serious adverse events were observed. CONCLUSIONS US-guided repetitive TPVB significantly reduced the HZ-BOI and the PHN incidence compared to antiviral therapy alone. It might be considered as an early intervention and preventive strategy to the development of PHN after acute HZ.KEY MESSAGEThis is a prospective randomized comparative study. We made a hypothesis that US-guided repetitive thoracic paravertebral block (TPVB) using a transverse short axial (TSA) approach to treat thoracic herpes zoster (HZ) in acute phase could reduce the burden of illness associated to acute pain. Moreover, this therapy might be a feasible preventive strategy to reduce the incidence of post-herpetic neuralgia.
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Affiliation(s)
- Yingchao Ma
- Department of Anesthesiology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Bingsi Li
- Department of Anesthesiology, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Lei Sun
- Department of Anesthesiology, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Xin He
- Department of Anesthesiology, 962 Hospital of Harbin, Harbin, China
| | - Shuang Wu
- Department of Anesthesiology, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Fan Shi
- Department of Anesthesiology, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
| | - Li Niu
- Department of Anesthesiology, Heilongjiang Red Cross Sengong General Hospital, Harbin, China
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Sollie M, Jepsen P, Sørensen JA. Patient-reported quality of life in patients suffering from acute herpes zoster-a systematic review with meta-analysis. Br J Pain 2022; 16:404-419. [PMID: 36032345 PMCID: PMC9411760 DOI: 10.1177/20494637211073050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Objectives Herpes Zoster (HZ) is a common painful, debilitating condition caused by reactivation of the varicella-zoster virus. It is characterized by a painful skin eruption which is very complex to treat. Studies have reported that HZ negatively affects Quality of Life (QoL), but no large systematic review on this topic has been published to date. This systematic review aims to summarize the current data on patient-reported QoL amongst patients diagnosed with HZ. Methods We searched Medline, Embase, Cochrane Library, CINAHL, and PsycINFO. The primary outcome was the change in percent impairment of QoL compared to normative data. Secondary outcomes were meta-analyses comparing reported QoL to a control group or normative data. Results We assessed a total of 536 studies for inclusion. Thirteen studies were included in the systematic review and five studies in the meta-analyses. The total number of patients was 5472. Conclusions This systematic review and meta-analysis found lower reported QoL amongst patients diagnosed with acute herpes zoster compared to normative values. Our data show that acute herpes zoster significantly reduces the quality of life of the patients affected.
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Affiliation(s)
- Martin Sollie
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Pernille Jepsen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark
| | - Jens A Sørensen
- Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Muñoz-Quiles C, López-Lacort M, Díez-Domingo J, Orrico-Sánchez A. Herpes zoster risk and burden of disease in immunocompromised populations: a population-based study using health system integrated databases, 2009-2014. BMC Infect Dis 2020; 20:905. [PMID: 33256624 PMCID: PMC7708196 DOI: 10.1186/s12879-020-05648-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background Estimate the incidence of herpes zoster (HZ), its complications and healthcare utilization rates in adults (≥ 18-years-old) with a wide range of immunocompromised (IC) conditions compared to IC-free cohort. Method A population-based retrospective study using the Valencia healthcare Integrated Databases (VID) (2009–2014). HZ and IC were defined using ICD-9 codes in primary care (PC) and hospitalization registers. Incidence rates (IR), risk of HZ, HZ-recurrence, HZ-complications and healthcare utilization rates were estimated in the IC-cohort compared to IC-free. Results The study population consisted of 4,382,590 subjects, of which 578,873 were IC (13%). IR (in 1000 persons-year) of HZ overall, in IC and in IC-free cohort was 5.02, 9.15 and 4.65, respectively. IR of HZ increased with age in both cohorts and it was higher for all IC conditions studied, reaching up to twelvefold in subjects with stem cell transplantation. IC subjects had 51% higher risk of developing HZ, 25% higher HZ-recurrence and the risk of HZ-complications was 2.37 times higher than in IC-free. HZ-related healthcare utilization was higher in the IC-cohort than in IC-free (number of hospitalizations 2.93 times greater, hospital stays 12% longer, 66% more HZ-specialist visits, 2% more PC visits, sick leaves 18% longer and 20% higher antiviral dispensation). Conclusions Patients suffering from all the IC conditions studied are at higher risk of developing HZ, HZ-recurrence and post-herpetic complications, which implies a substantial morbidity and a high consumption of resources. These results should be considered for vaccine policy implementation.
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Affiliation(s)
- Cintia Muñoz-Quiles
- Vaccines Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21, 46020, Valencia, Spain.
| | - Mónica López-Lacort
- Vaccines Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21, 46020, Valencia, Spain
| | - Javier Díez-Domingo
- Vaccines Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21, 46020, Valencia, Spain.,Universidad Católica de Valencia San Vicente Mártir, Carrer de Quevedo, 2, 46001, València, Spain
| | - Alejandro Orrico-Sánchez
- Vaccines Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Avda. Cataluña, 21, 46020, Valencia, Spain
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Salvetti A, Ferrari V, Garofalo R, Gazzaniga P, Guerroni A, Metrucci A, Sessa A, Severi ML, Nati G, Ruggeri M, Rossi A, Cappellari L, Gopala K, Tosatto R, Simone B. Incidence of herpes zoster and postherpetic neuralgia in Italian adults aged ≥50 years: A prospective study. Prev Med Rep 2019; 14:100882. [PMID: 31193254 PMCID: PMC6522697 DOI: 10.1016/j.pmedr.2019.100882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/23/2022] Open
Abstract
Herpes zoster (HZ) mainly affects older adults and immunocompromised individuals and is usually characterized by a unilateral painful skin rash. Its most common complication, postherpetic neuralgia (PHN), may cause chronic debilitating pain lasting for months or years. This study (ClinicalTrials.gov Identifier: NCT01772160) aimed to estimate the HZ incidence and the proportion of HZ patients with PHN in the Italian population aged 50 years or older. From 2013 to 2016, HZ-patients were recruited when presenting with acute HZ at 75 reporting general practitioners in Italy, covering 43,875 persons aged ≥50 years. PHN was defined as ‘worst pain’ rated ≥ 3 on the Zoster Brief Pain Inventory persisting or appearing over 90 days after rash onset. The overall HZ incidence rate per 1000 person-years (PY) was estimated as 6.46 (95% confidence interval [CI]: 5.99–6.95), increasing with age to 9.12/1000 PY (95% CI: 7.50–10.99) in 75–79 year-olds. Among 391 HZ-patients who completed the study, the overall proportion with PHN was 10.23% (95% CI: 7.41–13.67) and the highest proportion was 15.56% (95% CI: 6.49–29.46) for the 75–79 year-olds. Among the 128 patients (32.7%) who reported at least one pre-existing medical condition, 35.9% reported diabetes mellitus and 32.0% reported emotional problems, stress or depression. The study confirms previous findings that HZ and PHN cause an important clinical burden in older Italian adults. It also confirmed the age-related increasing risk of HZ and PHN. HZ has a strong incidence in the Italian population, the 2nd oldest worldwide. The estimated overall HZ incidence rate was 6.46 per 1000 person-years. The most common complication, PHN, was encountered by 10.23% of HZ patients. Strengths of the study are its prospective design and its large sample. Limitation: incidence may be underestimated due to cases missed in primary care.
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Affiliation(s)
- Andrea Salvetti
- Investigator site, Piazza Ponchielli 1, Toscana, Grosseto, GR 58100, Italy
| | - Vincenzo Ferrari
- Investigator site, Via Terranova 2, Puglia, Parabita, LE 73052, Italy
| | - Remigio Garofalo
- Investigator site, Via B. di Fredi 24, Toscana, Civitella Paganico, GR 58045, Italy
| | - Pietro Gazzaniga
- Investigator site, Via Garibaldi 1, Piemonte, Frugarolo, AL 15065, Italy
| | - Alessandro Guerroni
- Investigator site, Via Vittorio Veneto 44/A, Lombardia, Sesto Calende, VA 21018, Italy
| | - Antonio Metrucci
- Investigator site, Viale della Repubblica snc, Puglia, Cutrofiano, LE 73020, Italy
| | - Aurelio Sessa
- Investigator site, Via Cavour 26, Lombardia, Arcisate, VA, 21051, Italy
| | | | - Giulio Nati
- Investigator site, Via Pietro Tacchini 7, Lazio, Roma, RM 00197, Italy
| | - Mauro Ruggeri
- Investigator site, Central Site, Società Italiana di Medicina Generale (SIMG), Via del Pignoncino 9 SIMG, Toscana, Firenze, FI 50142, Italy
| | - Alessandro Rossi
- Investigator site, Central Site, Società Italiana di Medicina Generale (SIMG), Via del Pignoncino 9 SIMG, Toscana, Firenze, FI 50142, Italy
| | | | - Kusuma Gopala
- GSK, Embassy Links, Cunningham Road, SRT Road, #5, Bangalore 560052, India
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Toniolo-Neto J, Psaradellis E, Karellis A, Rampakakis E, Rockett TY, Sampalis JS, Johnson KD, Monsanto HA, Acosta CJ. Measuring herpes zoster disease burden in São Paulo, Brazil: a clinico-epidemiological single-center study. Clinics (Sao Paulo) 2018; 73:e243. [PMID: 30043824 PMCID: PMC6044137 DOI: 10.6061/clinics/2018/e243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 02/20/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Herpes zoster is characterized by acute neuritis and post-herpetic neuralgia. Currently, data concerning the zoster-associated impact on quality of life and healthcare resource utilization in Brazil are scarce. This study measured the zoster-associated burden in a Brazilian population. METHODS This was a prospective, observational, single-cohort study conducted in a primary hospital's emergency room in São Paulo, Brazil. Patients enrolled at various timepoints during a zoster episode were followed over 180 days. The Zoster Brief Pain Inventory and the Initial Zoster Impact Questionnaire assessed zoster-associated pain. The EuroQoL assessed the impact of herpes zoster and/or zoster-associated pain on quality of life. Healthcare resource utilization was assessed by patient-reported questionnaires. RESULTS One-hundred forty-six zoster patients were enrolled [mean (SD) age of 69.9 (10.9) years]. Mean (SD) worst pain scores decreased from 5.3 (3.5) at baseline to 1.9 (3.0) 180 days following rash onset. Mean (SD) EuroQoL scores significantly decreased from 0.9 (0.2) before rash appearance to 0.7 (0.2) after rash onset (p<0.001), followed by gradual improvements in quality of life over 180 days, with pre-herpes zoster quality of life achieved at the end of the observation period. The majority of patients purchased prescription medications (89.7%) and required doctor's office visits (65.8%) for zoster episodes. CONCLUSIONS Herpes zoster is associated with a significant disease burden, including zoster-associated pain, impaired quality of life and increased healthcare resource utilization in Brazil. These results support the implementation of early intervention and prevention programs such as vaccinations to reduce the herpes zoster-associated disease burden in Brazil.
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Affiliation(s)
- João Toniolo-Neto
- Nucleo de Pesquisas Clinicas e Envelhecimento (NUPEQ), Universidade Federal de Sao Paulo – Escola Paulista de Medicina (Unifesp-EPM), Sao Paulo, SP, BR
| | | | | | | | - Talita Y. Rockett
- Nucleo de Pesquisas Clinicas e Envelhecimento (NUPEQ), Universidade Federal de Sao Paulo – Escola Paulista de Medicina (Unifesp-EPM), Sao Paulo, SP, BR
| | - John S. Sampalis
- JSS Medical Research Inc., St-Laurent, QC, Canada
- *Corresponding author. E-mail:
| | - Kelly D. Johnson
- Center for Observational & Real-World Evidence, Vaccines, Merck & Co., Inc., Kenilworth, NJ, United States
| | - Homero A. Monsanto
- Center for Observational & Real-World Evidence, Latin America, MSD (IA) LLC, Carolina, Puerto Rico
| | - Camilo J. Acosta
- Center for Observational & Real-World Evidence, Vaccines, Merck & Co., Inc., Kenilworth, NJ, United States
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Muñoz-Quiles C, López-Lacort M, Díez-Domingo J. Risk and impact of herpes zoster among COPD patients: a population-based study, 2009-2014. BMC Infect Dis 2018; 18:203. [PMID: 29724175 PMCID: PMC5934818 DOI: 10.1186/s12879-018-3121-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 04/30/2018] [Indexed: 12/26/2022] Open
Abstract
Background The objective of this study was to assess the incidence of Herpes Zoster (HZ) among patients with chronic obstructive pulmonary disease (COPD) and the impact of HZ on the underlying COPD. Methods A retrospective cohort of all subjects older than 49 years was followed up between 2009 and 2014 using population and health databases of Valencia Region (Spain). HZ and COPD were identified using ICD-9 codes, differentiating COPD patients with inhaled corticosteroids prescriptions (COPD-ICS). The incidence of HZ was compared among 3 groups [non-COPD, COPD and COPD-ICS populations] and use of healthcare resource due to HZ for 6 months following HZ diagnosis through different statistical generalized linear models (GLM). We also compared resources consumption due to COPD before and after HZ. Results The cohort consisted of 2,289,485 subjects, including 161,317 COPD patients of which 29,708 were COPD-ICS. HZ incidence rates were 11 (95% confidence interval [CI]: 10.7–11.4) and 13 (95% CI: 12.3–13.8) cases/1000 persons-year for COPD and COPD-ICS populations respectively. Incidence increased with age in all groups. The risk of HZ rose by 45 and 61% among COPD and COPD-ICS patients respectively compared to non-COPD (95% credible intervals [CrI]: 1.41–1.5 and 1.52–1.71 respectively). COPD patients consumed more resources due to their HZ than non-COPD. There was no statistically significant impact of the HZ on the resources consumed due to COPD during the 6 months post-HZ compared to the 6 months pre-HZ. Conclusions The presence of COPD increases the risk, severity and impact of zoster episodes. Electronic supplementary material The online version of this article (10.1186/s12879-018-3121-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cintia Muñoz-Quiles
- Vaccine Research. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain. .,Vaccine Research Area, FISABIO-Public Health, Avda. Cataluña, 21, 46020, Valencia, Spain.
| | - Mónica López-Lacort
- Vaccine Research. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain
| | - Javier Díez-Domingo
- Vaccine Research. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, FISABIO-Public Health, Valencia, Spain.,Universidad Católica de Valencia San Vicente Mártir, Carrer de Quevedo, 2, 46001, València, Spain
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Abstract
Accumulating evidence suggests that diabetes mellitus (DM) represents an important risk factor for both herpes zoster and post-herpetic neuralgia. Moreover, post-herpetic neuralgia appears to be more severe and persistent in diabetic patients. On the other hand, a novel vaccine against varicella-zoster virus (VZV) was recently introduced in clinical practice. Given the increased risk and severity of herpes zoster infection in patients with DM, this vaccine might be useful in this population. However, there are limited data regarding the efficacy and safety of vaccination against herpes zoster in the diabetic population. The aim of the present review is to discuss the incidence and consequences of herpes zoster infection in DM and to comment on the role of vaccination against VZV in these patients.
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Affiliation(s)
- Marianthi Papagianni
- First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Symeon Metallidis
- First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study. BMC Public Health 2018; 18:369. [PMID: 29554872 PMCID: PMC5859733 DOI: 10.1186/s12889-018-5247-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/02/2018] [Indexed: 02/01/2023] Open
Abstract
Background The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. Methods Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool. Each case was then assigned one matched control according to age, gender, index date and propensity score. PHN cases were defined as those with persisting pain for more than 90 days after the onset of herpes zoster. Results Between 2004 and 2008, about 0.6 million patients were newly diagnosed with herpes zoster. The incidence increased with age, and most cases were identified during the summer period. Herpes zoster cases were found to have higher consumption of all types of healthcare services in the first year after the index date. Such increases were particularly obvious for patients with PHN, who showed incremental increases on average of 16.3 outpatient visits, 0.4 emergency room visits and 0.24 inpatient admissions per year. Conclusions The incidence of herpes zoster increased with age and changed according to the seasons. Patients with herpes zoster were associated with higher healthcare utilization and this increase in healthcare utilization was most obvious for herpes zoster patients with PHN. Electronic supplementary material The online version of this article (10.1186/s12889-018-5247-6) contains supplementary material, which is available to authorized users.
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