RZV Cuts Death but Has No Effect on Heart Health
Recombinant zoster vaccine (RZV) had no significant effect on major adverse cardiovascular events; however, it reduced all-cause mortality in patients with immune-mediated inflammatory diseases receiving Janus kinase inhibitors. The mortality benefit was particularly notable in women and patients aged 65 years or older.
METHODOLOGY:
Researchers conducted a new user design study utilizing the TriNetX network (United States) to assess the effect of RZV on cardiac health in patients with rheumatoid arthritis, spondyloarthritis, or psoriatic diseases who were receiving Janus kinase inhibitors.
Overall, 1756 patients and an equal number of propensity-matched control participants (mean age, 61.3 years; 76% women in both cohorts) were included from October 1, 2017, to March 31, 2024.
Primary outcome measures were major adverse cardiovascular events, including myocardial infarction, ischemic stroke, hemorrhagic stroke, heart failure, ventricular arrhythmia, and cardiac arrest, and the secondary outcome measure was all ‐ cause mortality.
TAKEAWAY:
No significant differences were reported in the risk for major adverse cardiovascular events between the vaccinated and unvaccinated cohorts (hazard ratio [HR], 1.121; 95% CI, 0.901-1.395); this finding also persisted when specific conditions were examined.
The risk for major adverse cardiovascular events also did not differ significantly based on factors such as age, sex, race, and zoster history.
The vaccinated cohort demonstrated a 39% reduction in all-cause mortality (HR, 0.610; 95% CI, 0.427-0.870; P = .005).
= .005). The risk for all-cause mortality was low particularly in women, those aged 65 years or older, White individuals, and those without zoster history.
IN PRACTICE:
'In elderly patients, the long-term persistence of vaccine efficacy may result in greater benefit, as this high-risk group is more susceptible to mortality following zoster reactivation. These findings underscore the importance of encouraging RZV vaccination in this high-risk population to achieve better survival outcomes,' the authors wrote.
SOURCE:
This study was led by James Cheng-Chung Wei and Pui-Ying Leong, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. It was published online on March 5, 2025, in Journal of Medical Virology .
LIMITATIONS:
The non-population–based nature of the TriNetX database might limit the generalizability of the study findings. Potential follow-up loss could have occurred because patients may have received vaccinations at healthcare organizations outside the TriNetX network, possibly leading to misclassification of the vaccination status. Additionally, disease activity assessment could not be conducted owing to electronic health record limitations.
DISCLOSURES:
The authors received no specific funding for this work. No conflicts of interest were reported.
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