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Monday, February 12th, 2018
Table of Contents

1 Introduction
5 PMID
 [F] Diseases Research  / PubMed Research Articles  /
ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an Infectious Diseases perspective (Immune checkpoint inhibitors, cell adhesion inhibitors, sphingosine-1-phosphate receptor modulators and proteasome inhibitors).

PubMed

 

Resource

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Feb ; ()

Authors

Redelman-Sidi G1; Michielin O2; Cervera C3; Ribi C4; Aguado JM5; Fernández-Ruiz M6; Manuel O7;

Author Information
  • 1Service of Infectious Disease, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA. Electronic address: redelmansidi@hotmail.com.
  • 2Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
  • 3Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • 4Department of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
  • 5Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI RD16/0016), Instituto de Salud Carlos III, Madrid, Spain.
  • 6Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI RD16/0016), Instituto de Salud Carlos III, Madrid, Spain.
  • 7Department of Infectious Diseases, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.

Abstract

BACKGROUND: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies.

AIMS: To review, from an Infectious Diseases perspective, the safety profile of immune checkpoint inhibitors, LFA-3-targeted agents, cell adhesion inhibitors, sphingosine-1-phosphate receptor modulators and proteasome inhibitors and to suggest preventive recommendations.

SOURCES: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family.

CONTENT: CTLA-4- and PD-1/PD-L1-targeted agents do not appear to intrinsically increase the risk of infection, but can induce immune-related adverse effects (irAEs) requiring additional immunosuppression. Although CD4+ T-cell lymphopenia is associated with alefacept, no opportunistic infections have been observed. Progressive multifocal leukoencephalopathy (PML) may occur during therapy with natalizumab (anti-α4-integrin monoclonal antibody [mAb]) and efalizumab (anti-CD11a mAb), but no cases have been reported to date with vedolizumab (anti-α4β7 mAb). In patients at high-risk for PML (positive anti-JC polyomavirus serology with serum antibody index >1.5 and duration of therapy ≥48 months), the benefit/risk balance of continuing natalizumab should be carefully considered. Fingolimod induces profound peripheral blood lymphopenia and increases the risk of varicella-zoster virus (VZV) infection. Prophylaxis with (val)acyclovir and VZV vaccination should be considered. Proteasome inhibitors also increase the risk of VZV infection, and antiviral prophylaxis with (val)acyclovir is recommended. Anti-Pneumocystis prophylaxis may be considered in myeloma multiple patients with additional risk factors (i.e., high-dose corticosteroids).

IMPLICATIONS: Clinicians should be aware of the risk of irAEs and PML in patients receiving immune checkpoint and cell adhesion inhibitors, respectively.

Copyright © 2018. Published by Elsevier Ltd.

PMID

29427804

Others

Publication Type: Journal Article, Review


This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.


Last Modified:   2016-03-27


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