P845 Increased incidence of herpes zoster in patients with Inflammatory Bowel Diseases in Europe

Abstract

Abstract Background Immunocompromised (IC) patients, including those with autoimmune Inflammatory Bowel Diseases (IBD), are at increased risk for herpes zoster (HZ). HZ affects one in three adults aged ≥50 years, with complications of post-herpetic neuralgia (PHN) in around one in ten affected adults. PHN impacts patients’ health-related quality of life and is difficult to treat. Both HZ and PHN place a financial burden on healthcare systems. The objective was to systematically review the incidence of HZ in IC populations. Methods A systematic literature review was performed to identify observational studies reporting on the HZ incidence in a broad range of IC populations in the European Union/European Economic Area, Switzerland and United Kingdom (2002-2022). The results for IBD patients are reported here. Results Overall, 26 studies reported HZ incidence rates, with three reporting on IBD patients. In Valencia, Spain, using hospital and primary care data in adult patients (≥18 years), HZ incidence rates were higher in IBD patients versus non-IC patients, and increased with age (Table 1). In this study, IBD versus non-IC patients had significantly higher rates of HZ complications (7.67 [3.51-14.57] vs. 2.64 [2.42-2.86] per 100,000 person-years [PY]) and of HZ recurrence (2.48 [2.06-2.96] vs. 1.56 [1.53-1.59] per 100 PY), driven by high rates in patients ≥60 years.1 In England, data from the Clinical Practice Research Datalink matched IBD patients (≥18 years) to non-IC patients. HZ incidence was higher in IBD versus non-IC patients and increased with age (Table 1).2 From German claims data (2012) in over ten million adults (≥18 years), HZ incidence in patients with ulcerative colitis and Crohn’s disease were higher than in the non-IC population (Table 1).3 Table 1. HZ incidence rate (per 1,000 person-years) in IBD versus non-IC patients Conclusion Three large real-world studies confirmed significantly higher HZ incidence rates in IBD versus non-IC patients, with higher rates in older age groups. These findings support healthcare providers and guideline committees in reinforcing HZ prevention strategies for IBD patients. An adjuvanted recombinant HZ vaccine is the first approved for use in IC populations, and may help reduce the healthcare system and patient burden.