Alemtuzumab‐induced Alopecia areata – a case report and systematic literature review of adverse events associated with Alemtuzumab

Dikeoulia, Elsa; Neufeld, Matthias; Pawlitzki, Marc; Böhm, Markus

doi:10.1111/ddg.14448

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Alemtuzumab, a CD52‐directed IgG1κ mAb approved for treatment of CLL, 161 has an unknown in vivo mechanism and an in vitro action involving complement‐dependent cytotoxicity, antibody‐dependent cellular cytotoxicity, and caspase‐independent cell death through a lipid raft‐dependent mechanism 358 . Dermatologic toxicities with alemtuzumab use include alopecia, maculopapular cAE, and vitiligo 99–104,121,122,161,162,185–187,205,220,221,359 . Table 3 lists the types of dermatologic toxicities seen with mAbs targeting CD52.…”

Section: Resultsmentioning

confidence: 99%

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

et al. 2022

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Background Since their first approval 25 years ago, monoclonal antibodies (mAbs) have become important targeted cancer therapeutics. However, dermatologic toxicities associated with non−immune checkpoint inhibitor (non‐ICI) mAbs may complicate the course of cancer treatment. Data on the incidence and types of these reactions are limited. Methods A comprehensive review was conducted on dermatologic toxicities associated with different classes of non‐ICI mAbs approved for treatment of solid tumors and hematologic malignancies. The review included prospective Phase 1, 2, and 3 clinical trials; retrospective literature reviews; systematic reviews/meta‐analyses; and case series/reports. Results Dermatologic toxicities were associated with several types of non‐ICI mAbs. Inflammatory reactions were the most common dermatologic toxicities, manifesting as maculopapular, urticarial, papulopustular/acneiform, and lichenoid/interface cutaneous adverse events (cAEs) with non‐ICI mAbs. Immunobullous reactions were rare and a subset of non‐ICI mAbs were associated with the development of vitiligo cAEs. Conclusion Dermatologic toxicities of non‐ICI mAbs are diverse and mostly limited to inflammatory reactions. Awareness of the spectrum of the histopathologic patterns of cAE from non‐ICI mAbs therapy is critical in the era of oncodermatology and oncodermatopathology.

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Section: Resultsmentioning

confidence: 99%

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

et al. 2022

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“…Recurrent and universal alopecia areata was reported following alemtuzumab treatment in a 28-year-old female and 27-year-old male patient. 35 An additional case of alopecia areata has been reported in a 31-year-old patient with relapsing-remitting MS. 36 Alopecia universalis has been reported in 3 cases of patients treated with alemtuzumab for MS. 37 , 38 Patchy alopecia was reported in a 34-year-old woman being treated for MS. 39 However, it is important to note that this patient was on thiamazole treatment for thyroid disease. Lastly, 1 case of recurrent alopecia totalis was described in a large, high disability, treatment-refractory MS clinic cohort.…”

Section: Discussionmentioning

confidence: 99%

Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies

Porwal

Salter

Patel

et al. 2022

J Cent Nerv Syst Dis

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BACKGROUND There is currently limited literature addressing the reporting of alopecia in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs). Anecdotal reports of hair thinning from patients on various DMTs prompted further investigation of a large database. OBJECTIVE To analyze total reports, source of reporting, age distribution, and sex distribution of alopecia associated with DMTs. METHODS FDA Adverse Event Reporting System (FAERS) public dashboard and OpenFDA database were analyzed for alopecia reports between January 1, 2009, and June 30, 2020, attributed to usage in MS of FDA approved DMTs. The main outcomes included total reports for each drug, age, sex distribution, and reporting source. OpenFDA data was used for statistical analyses including reporting odds ratios (ROR) and information components. RESULTS 8759 alopecia reports were identified among 44 114 adverse events in skin and subcutaneous tissue disorders (19.9%). 3701 (42.3%) with teriflunomide, 1675 (19.1%) with dimethyl fumarate, 985 (11.2%) with natalizumab, 926 (10.6%) with fingolimod, 659 (7.5%) with interferon beta-1a, 257 (2.9%) with glatiramer acetate, 243 (2.8%) with ocrelizumab, 124 (1.4%) with interferon beta-1b, 117 (1.3%) with alemtuzumab, 36 (.4%) with siponimod, 24 (.3%) with cladribine, and 12 (.1%) with rituximab. Reports were mostly made by patients (78.3%) and highest in fifth and sixth decades of life. OpenFDA analyses showed increased ROR (ROR 95% confidence interval) of alopecia in females with teriflunomide (18.00, 17.12-18.93), alemtuzumab (1.43, 1.16-1.76), dimethyl fumarate (1.26, 1.18-1.34), and ocrelizumab (1.28, 1.11-1.49). Increased ROR in males was associated with teriflunomide (24.65, 20.72-29.31). CONCLUSION We identified many reports of alopecia for DMTs in addition to teriflunomide. Within the limitations of the database, increased RORs of alopecia were observed for females treated with alemtuzumab, dimethyl fumarate, and ocrelizumab. The source of reporting was largely driven by female patients. Possible alopecia, even if transient, should be considered during patient education when starting DMTs.

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Alopecia areata – Current understanding and management

Lintzeri

Constantinou

Hillmann

et al. 2022

J Deutsche Derma Gesell

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Alopecia areata (AA) is a chronic, immune-mediated disease characterized by acute or chronic non-scarring hair loss, with a heterogeneity in clinical manifestations ranging from patchy hair loss to complete scalp and body hair loss. An overview of the up-to-date pathophysiology and the underlying signaling pathways involved in AA together with diagnostic and therapeutic recommendations will be provided. Current treatments, including topical, systemic and injectable interventions show varying response and frequent relapses reflecting the unmet clinical need. Thus, the new emerging concepts and therapeutic approaches, including Janus kinase inhibitors are eagerly awaited. Traditional and emerging therapies of AA will be discussed, in order to provide physicians with guidance for AA management. Since the latter is so challenging and often tends to take a chronic course, it can have an enormous psychosocial burden on patients, compromising their quality of life and often causing depression and anxiety. Therefore, the psychosocial aspects of the disease need to be evaluated and addressed, in order to implement appropriate psychological support when needed.

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Alemtuzumab‐induced Alopecia areata – a case report and systematic literature review of adverse events associated with Alemtuzumab

Cited by 4 publications

References 28 publications

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

The diverse landscape of dermatologic toxicities of non‐immune checkpoint inhibitor monoclonal antibody‐based cancer therapy

Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies

Alopecia areata – Current understanding and management

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