Background/Purpose: Patients with rheumatoid arthritis (RA) are at increased risk of developing herpes zoster (HZ). This study aimed to assess the effectiveness of recombinant zoster vaccine (RZV) in reducing both the incidence of HZ and all-cause mortality among individuals with RA.

Methods: We conducted a retrospective cohort study using data from the TriNetX U.S. Collaborative Network between October 1, 2017, and March 31, 2024. The study population consisted of RA patients who received RZV (RA-RZV cohort) and those who did not (RA control cohort). Propensity score matching (PSM) was employed to balance baseline characteristics between the groups, accounting for demographics, social economic status, lifestyles, medical utilization, comorbidities, and medications. The primary outcomes were the risk of HZ and all-cause mortality. PSM-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression models. Kaplan-Meier curves and Log-Rank tests were used to evaluate survival differences.

Results: After PSM, each cohort included 21,046 individuals. The RA-RZV group demonstrated significantly lower risks of HZ (HR: 0.836, 95% CI: 0.738–0.947) and all-cause mortality (HR: 0.606, 95% CI: 0.561–0.654). The HZ risk reduction was more pronounced in patients aged 50-64 years (HR: 0.731, 95% CI: 0.610–0.876), females (HR: 0.791, 95% CI: 0.684–0.915), White (HR: 0.808, 95% CI: 0.696–0.937), and Black/African American participants (HR = 0.685; 95% CI = 0.481–0.976).

Conclusion: RZV vaccination is associated with a reduced risk of HZ and mortality among RA patients aged 50 years and older. RZV vaccination should be prioritized among eligible RA patients.

Kaplan-Meier curve of herpes zoster infection

Kaplan-Meier curve of all-cause mortality

Study flow of patients selection

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effectiveness-of-recombinant-zoster-vaccine-in-reducing-herpes-zoster-incidence-and-all-cause-mortality-among-rheumatoid-arthritis-patients-a-retrospective-cohort-study-of-21046-individuals-from-tri/