Background/Purpose:

The presence of varicella zoster virus (VZV) signal in the temporal arteries of patients with giant cell arteritis has suggested a possible role of VZV in triggering the immunopathology of GCA. This calls into question whether VZV may also play a role in the development of polymyalgia rheumatic (PMR). We aimed to determine whether herpes zoster (HZ) infection is a risk factor for PMR.

Methods: All incident cases of PMR in a geographically-defined area diagnosed between 1990 and 2014 were identified. For each patient with PMR, a non-PMR control subject matched on age and sex was randomly selected from the same underlying population. Each control was assigned an index date corresponding to the PMR incident date of the matched case. The medical records of all patients with codes for HZ were reviewed to confirm the incident date and diagnosis.

Results:

The study included 541 patients with PMR and 541 subjects without PMR. The average age at PMR incidence (index date for the non-PMR cohort) was 74 years, and 349 (65%) subjects were female in each cohort. Prior to index date, 61 (11%) patients with PMR and 62 (11%) non-PMR patients had HZ infection (p=0.92).

Conclusion: Herpes zoster infection was not associated with an increased risk of PMR. Further work is needed to determine the etiology of PMR.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/herpes-zoster-as-a-risk-factor-for-polymyalgia-rheumatica-a-population-based-study/