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Based on other studied with Tofa and other JAK inhibitors, the Shingles risk for Tofa+MTX is the same as TOFA monotherapy, which is 3-4times higher than RA on MTX monotherapy. Hence the major risk with new drugs is with all the JAK inhibitors. The newly approved SLE drug, anifrolumab will have a high risk of Shingles, like the JAK inhibitors.