Skill Checkup: A 40-Year-Old Woman With Rheumatoid Arthritis Has Fever, Headache, Photophobia and Painful, Burning Rash

Heidi Moawad, MD


May 08, 2023

A study with data from nearly 14,000 patients with RA showed that exposure-adjusted event rates of HZ were highest for tsDMARDs. When data were adjusted for age, sex and glucocorticoids and weighted with inverse probability weights, tsDMARDs, anti-TNF-α treatment and B-cell-targeted therapy showed a significantly higher risk for HZ compared with conventional synthetic DMARDs.

The general practitioner recommends staying on the anti-TNF-α treatment for now but encourages the patient to speak with her rheumatologist about other treatment options that are available. The general practitioner tells the patient that the RA itself may have also contributed to her increased risk for HZ.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.