PDF(Pubmed)
Abstract：
BACKGROUND: Asthma is a common respiratory disease, which may be associated with an increased risk of herpes zoster (HZ), often a debilitating disease associated with severe pain. This is the first systematic review with the objective of summarising evidence on HZ burden in adults with asthma.
METHODS: A global systematic literature review and meta-analysis was conducted (MEDLINE and Embase, 2003-2024) on HZ burden (incidence, risk and complications) in adults (≥18 years) with asthma.
RESULTS: There were 19 studies included on HZ outcomes in adults with asthma. Pooled HZ incidence per 1000 person-years was 5.71 (95% CI 4.68-6.96) in adults aged ≥18 years (4.20 (95% CI 3.09-5.70) in those aged <60 years versus 10.33 (95% CI 9.17-11.64) in those aged ≥60 years). The pooled rate ratio for developing HZ was 1.23 (95% CI 1.11-1.35) in those aged ≥18 years and 1.36 (95% CI 1.15-1.61) in those aged ≥50 years. The risk of HZ was higher in people with asthma using systemic corticosteroids, long-acting β-agonists plus inhaled corticosteroids and \"add-on therapy\". Asthma was also associated with an increased risk of post-herpetic neuralgia (OR 1.21, 95% CI 1.06-1.37) and HZ ophthalmicus (OR 1.9, 95% CI 1.1-3.2). Differences in study design, setting, case definitions and follow-up durations led to heterogeneity.
CONCLUSIONS: This systematic literature review and meta-analysis found that adults with asthma have an increased risk of HZ, with higher risks in older age groups and in those on certain treatments, such as oral corticosteroids. HZ vaccines are available for adults, including those with comorbidities such as asthma, and can be considered as part of integrated respiratory care.
METHODS: A global systematic literature review and meta-analysis was conducted (MEDLINE and Embase, 2003-2024) on HZ burden (incidence, risk and complications) in adults (≥18 years) with asthma.
RESULTS: There were 19 studies included on HZ outcomes in adults with asthma. Pooled HZ incidence per 1000 person-years was 5.71 (95% CI 4.68-6.96) in adults aged ≥18 years (4.20 (95% CI 3.09-5.70) in those aged <60 years versus 10.33 (95% CI 9.17-11.64) in those aged ≥60 years). The pooled rate ratio for developing HZ was 1.23 (95% CI 1.11-1.35) in those aged ≥18 years and 1.36 (95% CI 1.15-1.61) in those aged ≥50 years. The risk of HZ was higher in people with asthma using systemic corticosteroids, long-acting β-agonists plus inhaled corticosteroids and \"add-on therapy\". Asthma was also associated with an increased risk of post-herpetic neuralgia (OR 1.21, 95% CI 1.06-1.37) and HZ ophthalmicus (OR 1.9, 95% CI 1.1-3.2). Differences in study design, setting, case definitions and follow-up durations led to heterogeneity.
CONCLUSIONS: This systematic literature review and meta-analysis found that adults with asthma have an increased risk of HZ, with higher risks in older age groups and in those on certain treatments, such as oral corticosteroids. HZ vaccines are available for adults, including those with comorbidities such as asthma, and can be considered as part of integrated respiratory care.
摘要：
背景：哮喘是一种常见的呼吸道疾病，这可能与带状疱疹（HZ）的风险增加有关，通常是一种与剧烈疼痛有关的使人衰弱的疾病。这是第一个系统评价，目的是总结成人哮喘患者HZ负担的证据。
方法：进行了全球系统文献综述（SLR）和荟萃分析（Medline和Embase，2003-2024),在HZ负担(发病率，风险，并发症）在成人（≥18岁）患有哮喘。
结果：有19项研究纳入了成人哮喘患者的HZ结局。≥18岁人群中每1000人年合并的HZ发生率为5.71（95％置信区间[CI]4.68-6.96）（<60岁人群为4.20[3.09-5.70]，≥60岁人群为10.33[9.17-11.64]）。在≥18岁的人群中，发展HZ的合并比率为1.23[1.11-1.35]，≥50岁的人群为1.36[1.15-1.61]。使用全身性皮质类固醇、长效β受体激动剂加吸入型皮质类固醇和“附加疗法”的哮喘患者发生HZ的风险更高。哮喘也与带状疱疹后神经痛的风险增加有关（比值比，OR1.21[1.06-1.37])和HZ眼药(OR1.9[1.1-3.2])。研究设计的差异，设置,案例定义，随访持续时间导致异质性。
结论：这项SLR和荟萃分析发现，患有哮喘的成年人患HZ的风险增加，老年群体的风险更高，在那些接受某些治疗的人中，如口服皮质类固醇。HZ疫苗可供成年人使用，包括有哮喘等合并症的患者，并且可以被视为综合呼吸护理的一部分。
方法：进行了全球系统文献综述（SLR）和荟萃分析（Medline和Embase，2003-2024),在HZ负担(发病率，风险，并发症）在成人（≥18岁）患有哮喘。
结果：有19项研究纳入了成人哮喘患者的HZ结局。≥18岁人群中每1000人年合并的HZ发生率为5.71（95％置信区间[CI]4.68-6.96）（<60岁人群为4.20[3.09-5.70]，≥60岁人群为10.33[9.17-11.64]）。在≥18岁的人群中，发展HZ的合并比率为1.23[1.11-1.35]，≥50岁的人群为1.36[1.15-1.61]。使用全身性皮质类固醇、长效β受体激动剂加吸入型皮质类固醇和“附加疗法”的哮喘患者发生HZ的风险更高。哮喘也与带状疱疹后神经痛的风险增加有关（比值比，OR1.21[1.06-1.37])和HZ眼药(OR1.9[1.1-3.2])。研究设计的差异，设置,案例定义，随访持续时间导致异质性。
结论：这项SLR和荟萃分析发现，患有哮喘的成年人患HZ的风险增加，老年群体的风险更高，在那些接受某些治疗的人中，如口服皮质类固醇。HZ疫苗可供成年人使用，包括有哮喘等合并症的患者，并且可以被视为综合呼吸护理的一部分。
