Stroke Risk Doubles in Autoimmune Disease and Shingles Patients

Patients with autoimmune diseases, like psoriasis, and infected with herpes zoster — commonly known as shingles – have a 50% higher risk of suffering a stroke.

It’s interesting to note the incidence of shingles has increased over the years, especially for patients treated with immunosuppressive therapies and biologics.

Leonard H. Calabrese, DO, vice chair of rheumatic and immunologic diseases, Cleveland Clinic, and team analyzed Medicare data from 2006 to 2012 to distinguish approximately 51,000 patients with shingles as well as any autoimmune disease like: ankylosing spondylitis, inflammatory bowel disease (IBD), psoriasis, psoriatic arthritis, or rheumatoid arthritis.

The researchers monitored the patients particularly for ischemic stroke hospitalizations following their shingles diagnoses for one, six, and 12-month follow-ups.

After the six-month mark, results indicated the incidence rate of hospitalized ischemic stroke was 9.8 for each 1,000 patient years, compared with a rate of 8.7 for 1,000 in two to six years.

Also, for two-thirds of the more complicated shingles patients, the hazard ratio for stroke was 3.2 in the first 30 days, compared to 1.6 in the uncomplicated group.

Calabrese remarked, “…one, prompt diagnosis and treatment of zoster is important to potentially reduce stroke risk, and two, for patients with immune mediated dermatologic disorders (such as psoriasis) on immunosuppressive therapy, preventative measurers (i.e. vaccination) are of increased importance now viewing the risk of stroke.”

The highlights of the study, presented at the 2015 American College of Rheumatology (ACR) and the Association for Rheumatology Health Professional (ARHP) Annual Meeting in San Francisco stressed the necessity to further develop strategies to reduce shingles among immunosuppressed patients.