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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)
- Source :
- Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background The present review is part of the European Society of Clinical Microbiology and Infectious Diseases (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 T-lymphocyte–associated antigen 4 (CTLA-4) and programmed death (PD)-1/PD-1 ligand 1 (PD-L1)-targeted agents do not appear to intrinsically increase the risk of infection but can induce immune-related adverse effects 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 ratio 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 immune-related adverse effects and PML in patients receiving immune checkpoint and cell adhesion inhibitors respectively.
- Subjects :
- Microbiology (medical)
Consensus
Efalizumab
Alefacept
Proteasome inhibitors
Antibodies, Monoclonal, Humanized
medicine.disease_cause
Communicable Diseases
Vedolizumab
Article
Immunocompromised Host
03 medical and health sciences
0302 clinical medicine
Natalizumab
Progressive multifocal leukoencephalopathy
Cell Adhesion
Humans
Medicine
CTLA-4 Antigen
Molecular Targeted Therapy
030212 general & internal medicine
Clinical Trials as Topic
business.industry
Leukoencephalopathy, Progressive Multifocal
Varicella zoster virus
Antibodies, Monoclonal
Fingolimod
General Medicine
medicine.disease
Ipilimumab
Immune checkpoint
Biological Therapy
Genes, cdc
Receptors, Lysosphingolipid
Nivolumab
Infectious Diseases
Immunology
Infection
business
Pembrolizumab
Proteasome Inhibitors
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 1198743X
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Clinical Microbiology and Infection
- Accession number :
- edsair.doi.dedup.....4021ef76ba0a7441178ca7fb4d893d2b