Do MS Treatments Raise the Risk of Shingles?

A new report shows that MS patients taking fingolimod have greater odds of developing the painful varicella-zoster rash.

People with multiple sclerosis (MS) who take fingolimod (Gilenya) are more likely to develop an infection with the varicella-zoster virus (VZV), or shingles, according to a study published in JAMA Neurology. Several top specialists collaborated to evaluate shingles risk and recommend ways to manage it.

The group determined that people with MS who are on fingolimod are nearly twice as likely to develop shingles as MS patients not on a disease modifying therapy (DMT), although the overall risk is still relatively small.The researchers examined the records of almost 7,500 patients who participated in the studies for fingolimod, looking for cases of shingles. They also examined cases reported since 2010 when the U.S. Food and Drug Administration approved fingolimod.For every one thousand healthy patients, four are expected to develop shingles, explained Dr. Jerry S. Wolinsky, a professor of neurology at the University of Texas Health Science Center in Houston, in an interview with Healthline. In MS patients who are not on therapy, “we think that number is probably closer to about six … around twice what it might be in the normal population.”

For those in the study who were taking fingolimod, the number of infections jumped to 11 per one thousand patient-years (patient-years are the total number of years patients are in a study). This is nearly double the rate of infections for MS patients in general.

“More than 100,000 patients to date have received Gilenya,” Novartis told Healthline in a statement. “The total patient exposure is now at approximately 172,500 patient years. The rate of VZV infections in clinical trials with fingolimod 0.5 mg was increased compared to placebo, but was overall low. This rate has remained stable in long-term studies as well as in the post-marketing setting.”