5PSQ-080 Identification of pharmacological interactions between ivacaftor/tezacaftor/elexacaftor and dietary supplements/herbs in patients with cystic fibrosis in an outpatient pharmaceutical care unit

Abstract

Patient 2, 43-year-old, woman with ankylosing spondylitis HLA-B27+ in treatment with adalimumab 5 months ago and no history of demyelinating diseases. She presented ataxia and hemihypoesthesia She was treated with methylprednisolone for 5 days with functional improvement stopping adalimumab treatment.In the MRI, multiple lesions with dissemination criteria in space (1 periventricular, 1 infratentorial), and in time (only one of them with gadolinium uptake, currently apparently asymptomatic), the patient met McDonald's criteria (2017) for MS with OCBs negative and she started treatment with ocrelizumab.Naranjo's algorithm determined as adverse drug reactions probable in patient 1 and possible in patient 2. Conclusion and Relevance A potential link between adalimumab and MS was related in these cases. Although this relationship have been associated in rare cases, adalimumab should be avoided in patients with history of demyelinating disorders. Patients should be informed of possible symptoms at the start of therapy and treatment should be discontinued if they develop them.