{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T07:32:31Z","timestamp":1770967951341,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Herpes zoster (HZ) has raised public concern. An increasing incidence of HZ can be seen in the immunocompromised population, such as the psoriasis patients taking biologics. Real-world evidences are still needed to investigate the risks of HZ among patients receiving different biologics treatments. This study aims to summarize the findings from cohort studies.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Herein, we performed a meta-analysis of cohort studies. We included studies referred to seven biologics (adalimumab, alefacept, efalizumab, etanercept, infliximab, rituximab, and ustekinumab) as well as methotrexate for psoriasis. We estimated summary relative risks (RRs) for HZ using pairwise and network meta-analysis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Overall, five studies were included for analysis. A total of 32827.6 patient-years were observed. The result of the meta-analysis showed that the pooled HZ incidence rate of adalimumab, which accounts for the most patient-years in our analysis, is 2.6 per 1,000 patient-years. Our analysis based on several cohorts showed an insignificant difference among the patients receiving adalimumab, alefacept, efalizumab, etanercept, infliximab, rituximab, ustekinumab, and methotrexate.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Based on this analysis, the type of mono-biologic treatment contributes little to the risk of HZ among psoriasis patients. Of note, the negative findings of our study do not mean the unnecessity of vaccination. More efforts must be taken to further determine HZ risk of different therapeutic strategies.<\/jats:p>","DOI":"10.3389\/fmed.2021.665559","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T04:21:09Z","timestamp":1622780469000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of Herpes Zoster Among Psoriasis Patients Taking Biologics: A Network Meta-Analysis of Cohort Studies"],"prefix":"10.3389","volume":"8","author":[{"given":"Zhenwei","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minxue","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"16082","DOI":"10.1038\/nrdp.2016.82","article-title":"Psoriasis","volume":"2","author":"Greb","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/s0140-673661909-7","article-title":"Psoriasis","volume":"386","author":"Boehncke","year":"2015","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.cell.2020.03.007","article-title":"Challenges, progress, and prospects of developing therapies to treat autoimmune diseases","volume":"181","author":"Fugger","year":"2020","journal-title":"Cell"},{"key":"B4","first-page":"1","article-title":"Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"57","author":"Harpaz","year":"2008","journal-title":"MMWR Recomm Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1097\/00002508-200211000-00002","article-title":"Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy","volume":"18","author":"Schmader","year":"2002","journal-title":"Clin J Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1080\/09546634.2018.1445193","article-title":"Biological treatment for psoriasis and the risk of herpes zoster: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR)","volume":"30","author":"Shalom","year":"2019","journal-title":"J Dermatolog Treat"},{"key":"B7","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1159\/000338691","article-title":"Herpes zoster in patients treated with biologicals","volume":"224","author":"Failla","year":"2012","journal-title":"Dermatology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1111\/j.1468-3083.2011.04230.x","article-title":"Risk of Herpes zoster in patients with psoriasis treated with biologic drugs","volume":"26","author":"Dreiher","year":"2012","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1001\/jamadermatol.2015.0718","article-title":"Risk of serious infection with biologic and systemic treatment of psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR)","volume":"151","author":"Kalb","year":"2015","journal-title":"JAMA Dermatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1001\/jamadermatol.2014.4956","article-title":"Systemic therapy for psoriasis and the risk of herpes zoster: a 500,000 person-year study","volume":"151","author":"Shalom","year":"2015","journal-title":"JAMA Dermatol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"ofw205","DOI":"10.1093\/ofid\/ofw205","article-title":"Risk of herpes zoster in individuals on biologics, disease-modifying antirheumatic drugs, and\/or corticosteroids for autoimmune diseases: a systematic review and meta-analysis","volume":"3","author":"Marra","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2328","DOI":"10.1002\/art.39670","article-title":"Risk of Herpes Zoster in autoimmune and inflammatory diseases: implications for vaccination","volume":"68","author":"Yun","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1016\/j.jid.2018.01.039","article-title":"Risk of serious infection, opportunistic infection, and herpes zoster among patients with psoriasis in the United Kingdom","volume":"138","author":"Takeshita","year":"2018","journal-title":"J Invest Dermatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1111\/jdv.12307","article-title":"The risk of herpes zoster during biological therapy for psoriasis and other inflammatory conditions","volume":"28","author":"Adelzadeh","year":"2014","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.jaad.2019.03.017","article-title":"A systematic review of herpes zoster incidence and consensus recommendations on vaccination in adult patients on systemic therapy for psoriasis or psoriatic arthritis: from the Medical Board of the National Psoriasis Foundation","volume":"81","author":"Baumrin","year":"2019","journal-title":"J Am Acad Dermatol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.665559\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T04:21:13Z","timestamp":1622780473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.665559\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,4]]},"references-count":15,"alternative-id":["10.3389\/fmed.2021.665559"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.665559","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,4]]},"article-number":"665559"}}