Canakinumab
- PDF / 173,488 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 84 Downloads / 123 Views
1 S
Various toxicities: case report In a case report, 3 patients (2 boys and 1 woman) [exact ages not stated] were described, who developed severe cystic acne, itching erythematous rash, pseudo-folliculitis, herpes simplex virus (HSV) eruption, perianal abscess, pseudo-folliculitis, erythematous rash or Staphylococcus aureus infection during treatment with canakinumab for mevalonate kinase deficiency (MKD) [routes and durations of treatments to reactions onsets not stated/not all dosages and outcomes stated]. Case 1: An adolescent boy had a history of MKD. He also had received treatment with etanercept, anakinra, canakinumab, without any or partial control of symptoms. At age of 15 years, he developed severe cystic acne of the face. He received various treatments including adapalene, minocycline and clindamycin, benzoyl peroxide, dapsone gel with no significant improvement. These manifestations worsened in the weeks after receiving canakinumab injection and improved before 2 weeks of the following administration. Thus, a diagnosis was made with drug induced skin manifestation. He then underwent surgical excision of the main lesion along with isotretinoin treatment and achieved a prolonged remission. After 2 years, he had good control of the inflammatory disease but presented a perianal abscess with fever. He was then treated with ciprofloxacin and underwent surgical excision. Case 2: An adult woman had a history of MKD. At the age of 16 years, she was found to have Henoch-Schonlein purpura. She also had a history of receiving anakinra but exhibited only partial improvement. Therefore, she was enrolled in a trial with canakinumab and in the last phase of the study, clinical remission was maintained on canakinumab 150mg every 5 weeks. Since then, she developed several cutaneous manifestations, which were different from the previous. After 8 months of receiving canakinumab therapy, she developed an itching erythematous rash of the right arm, back and groins, which resolved spontaneously. The rash was further characterised by maculo-papular elements (2–3mm of diameter) emerging in pustules and scab with minimal bloody oozing. It was finally interpreted as pseudo-folliculitis. She also developed recurrent HSV eruption of the lips and sometimes accompanied by diffuse. She was then treated with topical aciclovir [acyclovir]. She did not stop receiving canakinumab in the last 3 years and did not have any more cutaneous complaints. Case 3: A boy had a history of MKD and membranoproliferative glomerulonephritis, for which he was treated with anakinra and unspecified ACE-inhibitors. At the age of 3 years, he was found to have Henoch-Schonlein purpura, for which unspecified corticosteroid was added to anakinra therapy. Due to recurrent oral aphthae, he was enrolled in a trial with canakinumab 150mg every 4 weeks and obtained a fair control of the disease, rarely requiring glucocorticoids add-on treatment. However, after 2 years of receiving canakinumab therapy, he developed an erythematous rash in the armpit area, which was c
