Background: This study aimed to determine the association between immune checkpoint inhibitors (ICIs) and the risk of herpes zoster (HZ) incidence in patients with lung cancer. Method: We obtained national claims data of 51,021 patients from South Korea with lung cancer between August 2017 and December 2021. The study population was classified into ICI and non-ICI groups based on the prescription of ICIs at least once during the study period. To estimate the effects of ICIs treatment compared with those without ICIs treatment on HZ incidence, we used the Cox proportional hazards model adjusted for sex, age, comorbidities, and concomitant use of immunosuppressive drugs. Stratified analyses based on sex, age, and comorbidities were conducted to identify corresponding risk factors. Results: Of the 51,021 study participants, 897 (1.8%) were prescribed ICIs and 2262 (4.4%) were diagnosed with HZ. Approximately 75.6% of the patients receiving ICIs were male, and the prevalence of diabetes, cardiovascular disease, and chronic lung disease in the ICI group was significantly lower than that in the non-ICIs group. The Kaplan–Meier plot showed that the probability of incidence of HZ in the ICIs group was lower than that in the non-ICIs group. Additionally, treatment with ICIs was associated with a 31% lower incidence of developing HZ when compared to that seen without ICIs treatment (95% confidence interval [CI], 0.48–1.00). This association was stronger in females (hazard ratio [HR], 0.42; 95% CI, 0.19–0.94) and those less than 68 years of age (HR, 0.58; 95% CI, 0.34–0.99). Conclusions: In these real-world data from an Asian population with lung cancer, ICIs treatment might be associated with a reduced risk of HZ compared to that without ICIs treatment.
背景：本研究旨在探讨免疫检查点抑制剂（ICIs）与肺癌患者带状疱疹（HZ）发病风险之间的关联。方法：我们获取了2017年8月至2021年12月期间韩国51,021例肺癌患者的全国性理赔数据。根据研究期间是否至少处方过一次ICIs，将研究人群分为ICI组和非ICI组。为评估ICIs治疗相较于非ICIs治疗对HZ发病率的影响，我们采用经性别、年龄、合并症及免疫抑制剂合并使用情况校正的Cox比例风险模型进行分析，并基于性别、年龄和合并症进行分层分析以识别相应风险因素。结果：在51,021名研究参与者中，897人（1.8%）曾处方ICIs，2262人（4.4%）被诊断为HZ。接受ICIs治疗的患者中约75.6%为男性，且ICI组的糖尿病、心血管疾病和慢性肺病患病率显著低于非ICI组。Kaplan-Meier曲线显示ICI组的HZ发病概率低于非ICI组。此外，与未接受ICIs治疗相比，ICIs治疗与HZ发病率降低31%相关（95%置信区间[CI]为0.48-1.00）。这种关联在女性（风险比[HR]为0.42；95% CI为0.19-0.94）和年龄小于68岁的人群（HR为0.58；95% CI为0.34-0.99）中更为显著。结论：基于亚洲肺癌人群的真实世界数据，ICIs治疗可能较非ICIs治疗降低带状疱疹的发病风险。
肿瘤(癌症)患者之家