Shingrix for Herpes Zoster: A Review

Radhika A. Shah, BS, MS; Allison L. Limmer, BA, BS; Crystal E. Nwannunu, BS; Ravi R. Patel, MD; Uyen Ngoc Mui, MD; Stephen K. Tyring, MD, PhD

Disclosures

Skin Therapy Letter. 2019;24(4):5-7. 

In This Article

Abstract and Introduction

Abstract

Herpes zoster (HZ), also known as shingles, results from reactivation of the latent varicella-zoster virus (VZV), which commonly causes chickenpox in childhood. Greater than 90% of adults are infected with this virus, putting them at risk for reactivation. HZ presents as a painful, vesicular rash distributed in a unilateral and dermatomal pattern along dorsal root or cranial nerve ganglia. The rash often presents with prodromal symptoms and progresses to include clear vesicular clusters, evolving through stages of pustulation, ulceration, and crusting. HZ therapy currently involves the use of antiviral agents and pain management; however, HZ prophylaxis has been strongly recommended in older adults through vaccination with a live attenuated vaccine, Zostavax®. A new recombinant subunit vaccine, HZ/su (Shingrix®), is the subject of this review. In clinical trials, HZ/su demonstrated an overall vaccine efficacy of 97.2% among participants 50 years of age or older, indicating a significantly reduced risk of HZ in these individuals. Shingrix® was approved by the US FDA in October 2017 as HZ prophylaxis.

Introduction

Herpes zoster (HZ), also known as shingles, results from reactivation of the latent varicella-zoster virus (VZV), which commonly causes chickenpox in childhood. HZ presents as a painful, vesicular rash distributed in a unilateral and dermatomal pattern along dorsal root or cranial nerve ganglia.[1] This painful rash negatively affects patients' quality of life (QoL) by impairing physical, emotional, and social functioning.[2] Greater than 90% of adults are infected with this virus, putting them at risk for reactivation. Reactivation often occurs in adults over the age of 50 due to immunosenescence but can occur at any age, especially in those who are immunocompromised.[1] Complications of HZ include postherpetic neuralgia, which occurs in 10–20% of patients and increases in frequency and severity with age.[1,2]

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....