Case-control study examining the association between herpes zoster and oral corticosteroids use in older adults

Little research focuses on the association between herpes zoster and oral corticosteroids use in older adults. The aim of the study was to explore this issue.

We performed a case-control study using the database of the Taiwan National Health Insurance Program. There were 10,912 participants aged 65 years and older with newly diagnosed herpes zoster in 2000-2013 as the cases. We randomly selected 42,676 sex-matched and age-matched participants without herpes zoster as the controls. Ever use of oral corticosteroids was defined as participants who at least had a prescription for oral corticosteroids before the index date. Never use was defined as participants who did not have a prescription for oral corticosteroids before the index date. The odds ratio (OR) and 95% confidence interval (CI) for herpes zoster associated with oral corticosteroids use were estimated using the logistic regression model.

The adjusted OR of herpes zoster was 3.13 for participants with ever use of oral corticosteroids (95% CI 2.84-3.46), compared with never use. In a further analysis, the adjusted ORs of herpes zoster were 3.10 for cumulative duration of oral corticosteroids use < 12 months (95% CI 2.81-3.42) and 3.65 for cumulative duration ≥ 12 months (95% CI 3.20-4.18).

Older adults with oral corticosteroids use are associated with a threefold increase in odds of herpes zoster in Taiwan. There is a duration-related effect of oral corticosteroids use on the risk of herpes zoster.