HZ studies characteristics and HZ incidence rate (IR), incidence rate ratio (IRR) and HR according to AIIRD
| Author, Year | Country | Study design | AIIRD, Controls, Sample size | HZ diagnosis /ascertainment | Incidence/ 1000 PY (95% CI) AIIRD | Incidence/ 1000 PY (95% CI) Controls | IRR (95% CI) or HR (95% CI) | LoE |
| Rheumatoid arthritis | ||||||||
| Galloway 201327 | UK | Prospective cohort (BSRBR) | 15 554 RA: 3673nbDMARD; 11 881 TNFi | Patient and/or physician report confirmed by medical records | TNFi 16 (1.3 to 2.0); nbDMARD 8 (0.6 to 1.1) | NA | NA | 2b |
| Veetil 201325 | USA | Retrospective, population- based cohort | 830 RA 830 Controls | ICD-9 confirmed by medical records | 12.1 (9.6 to 14.9) | 5.4 (3.9 to 7.2) | HR 2.4 (1.7 to 3.5) | 2b |
| Widdifield 201326 | Canada | Retrospective, population- based cohort | 86 039 RA | ICD-9 or ICD-10 | 8.5 (8.3 to 8.8) | NA | NA | 2b |
| Winthrop 201329 | USA | Cohort (data claim) | 36 212 RA: 11 828 nbDMARD 24 384 TNFi | ICD-9 and use of antiviral medication within 30 days of the code | csDMARD: 12.7 (10.3 to 15.6) TNFi: 12.1 (10.7 to 13.6) | NA | NA | 2b |
| Che 201452 | Global | Systematic literature review and meta-analysis | 163 077 RA patient years | NA | NA | NA | Pooled risk ratio 1.6 (1.2 to 2.2) | 2a |
| Chen SY 201428 | USA | Cohort (data claim) | 571 555 RA | ICD-9 | 12.2 (12.0 to 12.5) | 4.8 (4.8 to 4.8) | IRR/Comparison by age groups (yo): 50 to 59 vs 18 to 49 1.5 (1.5 to 1.6) 60 to 64 vs 18 to 49 1.8 (1.7 to 2.0) ≥65 vs 18 to 49 2.2 (2.1 to 2.3) | 2b |
| Nakajima 201530 | Japan | Cohort | 7986 RA | Patient report confirmed by medical records | 9.1 (6.2 to 12.9) | NA | NA | 2b |
| Segan 201531 | Australia | Cohort (survey) | 1870 RA | Patient report confirmed by physician | 15.9 (13.5 to 18.8) | NA | NA | 4 |
| Pappas 201532 | USA | Cohort (CORRONA) | 28 852 RA | Rheumatologist report | 7.7 (7.1 to 8.2) | NA | NA | 2b |
| Yun 201533 | USA | Cohort (data claim) | 29 129 RA (bDMARD only) | ICD-9 and claim for an antiviral medication within 30 days of the code | Range by specific drug: 16.1 (8.9 to 29.1) – 24.5 (15.7 to 38.5) | NA | NA | 2b |
| Yun 201634 | USA | Cohort (data claim) | 50 268 RA 328 580 controls | ICD-9 | Range by age groups: 6.6 to 21.3 (CI NA) | 5.3 range by age groups: 2.7 to 10.6) (CI NA) | NA | 2b |
| Curtis 201635 | USA | Cohort (data claim) | 69 726 RA (bDMARD or tofacitinib only) | ICD-9 and antiviral drugs within 7 days of the diagnosis code | Range by specific drug: 4.79 (4.3 to 5.3) – 7.61 (6.1 to 9.6) | NA | NA | 2b |
| Burmester 201736 | Global | Cohort (pooled analysis of RCT and extension studies of adalimumab) | 15 152 RA (treated with adalimumab) | Adverse event as reported in clinical trials | 17 (CI NA) | NA | NA | 2b |
| Harada 201737 | Japan | Cohort (REAL database) | 1987 RA | Medical records and antiviral medication use | 6.7 (4.9 to 8.8) | NA | NA | 2b |
| Cohen 201738 | Global | Cohort (pooled analysis of RCT and extension studies of tofacitinib) | 6194 RA | Adverse event as reported in clinical trials | 39.0 (36.0 to 42.0) | NA | NA | 2b |
| Liao 201739 | Taiwan | Retrospective, population- based cohort | 27 609 RA 110 436 controls | ICD-9 | 18.3 (CI NA) | 7.2 (CI NA) | HR: 2.5 (2.4 to 2.7) | 2b |
| Kawai 201753 | Global | SLR and meta-analysis | RA | NA | NA | NA | Pooled risk ratio 1.7 (1.4 to 2.0) | 2a |
| Sakai 201740 | Japan | Cohort (data claim) | 6712 RA 33 560 controls | ICD-10 and antiviral medication use | 14.2 (11.1 to 14.9) | 8.3 (7.6 to 9.0) | IRR: 1.7 (1.5 to 2.0) | 2b |
| Psoriatic Arthritis | ||||||||
| Zisman 201641 | Israel | Cohort (data claim) | 3131 PsA | ICD-9 and antiviral medication use (≥5 days course) | 9.06 (7.8 to 10.5) | NA | NA | 2b |
| Yun 201634 | USA | Cohort (data claim) | 2609 PsA 328 580 controls | ICD-9 | Range by age groups: 8.5 to 19.4 (CI NA) | 5.3 (range by age groups: 2.7 to 10.6) (CI NA) | NA | 2b |
| Ankylosing spondylitis | ||||||||
| Yun 201634 | USA | Cohort (data claim) | 1011 AS 328 580 controls | ICD-9 | Range by age groups: 5.1 to 26.3 (CI NA) | 5.3 (range by age groups: 2.7 to 10.6) (CI NA) | NA | 2b |
| Lim 201842 | Korea | Cohort (data claim) | 1079 AS | ICD-10 and antiviral medication use at the same time | 11 (8.2 to 14.3) | NA | NA | 2b |
| Psoriatic arthritis, psoriasis, ankylosing spondylitis | ||||||||
| Winthrop 201329 | USA | Cohort (data claim) | 12 137 PsA, psoriasis, AS (7047 csDMARD, 5090 TNFi) | ICD-9 and use of antiviral medication within 30 days of the code | csDMARDs: 6.9 (4.7 to 10.0) TNFi: 4.4 (2.8 to 7.0) | NA | NA | 2b |
| Systemic lupus erythematosus | ||||||||
| Borba 201043 | Brazil | Cohort | 1145 SLE | Clinical diagnosis | 6.4 (CI NA) | NA | NA | 2b |
| Chen HH 201144 | Taiwan | Retrospective, population- based cohort | 10 337 SLE 62 022 controls | ICD-9 | 37.7 (25.5 to 40.0) | 5.1 (4.8 to 5.4) | IRR: 2.5 (1.8 to 3.4) | 2b |
| Chakravarty 201345 | USA | Cohort (National Data Bank for Rheumatic Diseases) | 1485 SLE 2775 controls | Patient report | 16.2 (12.4 to 21.1) | 10.7 (7.6 to 15) | HR 1.7 (1.1 to 2.7) | 2b |
| Chen SY 201428 | USA | Cohort (data claim) | 144 137 SLE | ICD-9 | 15.2 (14.7 to 15.7) | 4.8 (4.8 to 4.8) | IRR/Comparison by age groups (yo): 50 to 59 vs 18 to 49 2 (1.1 to 1.2) 60 to 64 vs 18 to 49 1.5 (1.3 to 1.7) ≥65 vs 18 to 49 1.8 (1.6 to 2.0) | 2b |
| Kawai 201753 | Global | SLR and meta-analysis | SLE | NA | NA | NA | pooled risk ratio 2.10 (1.4 to 3.2) | 2a |
| Yun 201634 | USA | Cohort (data claim) | 8395 SLE 328 580 controls | ICD-9 | 19.9 (range by age groups: 15.2 to 24.6) (CI NA) | 5.3 (range by age groups: 2.7 to 10.6) (CI NA) | NA | 2b |
| Sjögren | ||||||||
| Chen JY 201546 | Taiwan | Retrospective, population- based cohort | 4287 Sjögren 25 722 controls | ICD-9 | 18.74 (CI NA) | 8.55 (CI NA) | HR 1.7 (1.5 to 1.9) | 2b |
| Polymyositis/Dermatomyositis | ||||||||
| Fardet 200947 | France | Retrospective inception cohort | 121 DM | Physician report | 33 (CI NA) | NA | NA | 4 |
| Marie 201148 | France | Cohort | 279 PM/DM | Medical records | 33 (CI NA) | NA | NA | 4 |
| Tsai 201549 | Taiwan | Retrospective, population- based cohort | 2023 PM/DM 7409 controls | ICD-9 | 35.8 (CI NA) | 7.01 (CI NA) | HR 3.9 (3.2 to 4.8) | 2b |
| Robinson 201650 | USA | Retrospective cohort | 103 DM 152 controls | Medical records confirmed by dermatologist | 55.4 (CI NA) | 3.9 (CI NA) | NA | 2b |
| Giant cell arteritis | ||||||||
| Schafer 201051 | USA | Cohort (data claim) | 204 GCA 407 controls | Healthcare provider report, ICD-9 code confirmed by medical records | Range by age groups: 11.3 to 14 (CI NA) | Range by age groups: 4.6 to 12.1 (CI NA) | HR 1.22 (0.7 to 2.1) | 2b |
AIIRD, autoimmune inflammatory rheumatic disease(s); BSRBR, The British Society for Rheumatology Biologics Register; CORRONA, The Consortium of Rheumatology Researchers of North America; DM, dermatomyositis; GCA, giant cell arteritis; IR, incidence ratio; IRR, incidence rate ratio; LoE, level of evidence; NA, non-available/non-applicable; nbDMARD, non-biologic disease modifying anti-rheumatic drug; PM, polymyositis; PsA, psoriatic arthritis; RA, rheumatoid arthritis; RCT, randomised controlled trial; SLE, systemic lupus erythematosus; SSc, systemic sclerosis; TNFi, tumour necrosis factor inhibitor(s).