Herpes Zoster Poses Significant Healthcare Burden for Asthma Patients: Study Finds

The researchers found that patients with asthma had a higher incidence of herpes zoster than those without asthma, and among patients with asthma HZ, added to their healthcare resource use and costs.

"Research comparing adults with and without asthma in the USA revealed a higher HZ incidence among those with asthma (11.59 per 1000 person-years versus 7.16 per 1000 person-years; adjusted incidence rate ratio of 1.34)," the researchers reported.

The study, published in BMJ Open Respiratory Research, also exposed a concerning trend of heightened healthcare resource utilization among asthma patients with HZ, including increased inpatient stays, OPD appointments, and ER visits.

Asthma, a chronic respiratory condition characterized by airway inflammation, affects millions worldwide. Patients with asthma are known to have a compromised immune system, which may increase susceptibility to infections and other health complications. Herpes zoster is a painful condition caused by varicella-zoster virus reactivation. David Singer, GSK, Philadelphia, Pennsylvania, USA, and colleagues aimed to compare HZ incidence in adults with asthma versus adults without asthma. They also compared healthcare resource use and direct costs in adults with HZ and asthma versus adults with asthma alone in the USA.

For this purpose, the researchers conducted a retrospective longitudinal cohort study including adults aged ≥18 years, across the USA. Patients were identified from Optum’s deidentified Clinformatics Data Mart Database, an administrative claims database, between 2015 and 2020, including commercially insured and Medicare Advantage with Part D beneficiaries.

Using the International Classification of Diseases 10th Revision, Clinical Modification codes, the team identified cohorts of patients with and without asthma, and separate cohorts of patients with asthma and HZ and with asthma but not HZ. HZ incidence, costs, and healthcare resource use were compared, adjusting for baseline characteristics, between the relevant cohorts using generalized linear models.

The following were the key findings of the study:

• HZ incidence was higher in patients with asthma (11.59 per 1000 person-years) than those without asthma (7.16 per 1000 person-years).
• The adjusted incidence rate ratio (aIRR) for HZ in patients with asthma, compared with patients without asthma, was 1.34.
• Over 12 months of follow-up, patients with asthma and HZ had more inpatient stays (aIRR 1.11), emergency department visits (aIRR 1.26) and outpatient visits (aIRR 1.19), and direct healthcare costs that were US dollars ($) 3058 higher than patients with asthma without HZ.

In conclusion, the study underscores the urgent need for proactive healthcare approaches that integrate comprehensive management strategies for asthma and herpes zoster to improve outcomes and quality of life for affected individuals.

Reference:

Singer D, Thompson-Leduc P, Ma S, et al. Herpes zoster burden in patients with asthma: real-world incidence, healthcare resource utilisation and cost. BMJ Open Respiratory Research 2024;11:e002130. doi: 10.1136/bmjresp-2023-002130