Cervical cancer in a woman associated with long-term efalizumab therapy

Morse, Lisa; Yarbrough, Lee; Hogan, Daniel J.

doi:10.1016/j.jaad.2005.02.008

Cited by 13 publications

(4 citation statements)

References 4 publications

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“…4 Interestingly, the development of blood and solid tumors including cervical cancer in human papilloma virus carriers has been reported in patients treated with efalizumab through impaired T-cell activity. 5,6 In conclusion, our case, added to the report by Tanaka and Urata, 1 clearly demonstrates that immunomodulation obtained through biologic agents (not only anti-TNF) recapitulates an accelerated version of the natural history of HBV infection including the development/ progression of HCC.…”

Section: Letter To the Editorsupporting

confidence: 51%

“…Although the risk of HBV reactivation after anti‐CD11a monoclonal antibody‐mediated immunosuppression is not well defined, suppression of T‐lymphocyte function may promote viral reactivation, as in the case of John Cunningham virus 4 . Interestingly, the development of blood and solid tumors including cervical cancer in human papilloma virus carriers has been reported in patients treated with efalizumab through impaired T‐cell activity 5,6 …”

mentioning

confidence: 99%

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Hepatocellular carcinoma in a patient treated with efalizumab for psoriasis

Lonardo¹,

Nascimbeni²,

Ballestri³

et al. 2012

Hepatology Research

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Section: Letter To the Editorsupporting

confidence: 51%

mentioning

confidence: 99%

Hepatocellular carcinoma in a patient treated with efalizumab for psoriasis

Lonardo¹,

Nascimbeni²,

Ballestri³

et al. 2012

Hepatology Research

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“…I usually perform a follow‐up visit after the first month of treatment, and then every 3 months thereafter, monitoring the blood cell count and serum biochemical parameters. There are numerous studies, clinical trials and real‐life case series that confirm the efficacy and safety of efalizumab in the treatment of moderate‐to‐severe plaque psoriasis and in long‐term use 89,96–113 . My experience is that in those who respond to efalizumab, effectiveness is maintained throughout the course of therapy.…”

Section: Consultationmentioning

confidence: 96%

Alice, Eloi, Magali and Robert: the lives of four patients with psoriasis and the therapeutic approaches of eight European experts

Dubertret

Chimenti

Christophers

et al. 2009

British Journal of Dermatology

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“…73 Case reports support the potential for an increased malignant risk resulting from the immunosuppressive effects of the medication. 52,72 More long-term control studies will help clarify the significance of such reports. So far, open-label extension clinical trials have also not demonstrated an increased risk of malignancy in psoriasis patients treated with long-term efalizumab therapy.…”

Section: Summary-efalizumabmentioning

confidence: 99%

Biologic Therapy and the Risk of Malignancy in Psoriasis

Wolinsky

Lebwohl

2011

Psoriasis Forum

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Biologic agents are currently regarded as a highly efficacious systemic treatment for moderate to severe psoriasis. However, their use in patients with a history of malignancy or an increased risk of cancer is not recommended. The current recommendations are based on several case reports and observational studies, as well as data from randomized, controlled trials, associating these medications with tumorigenic properties. Furthermore, some reports describe malignancies arising de novo in patients using biologic agents. Psoriasis patients are at an increased risk of lymphoproliferative diseases and nonmelanoma skin cancers because of the inflammatory nature of the disease. A blockade of tumor necrosis factor-alpha (TNF-α) reduces inflammation but also may enhance tumor proliferation. Trials have not shown a significant increase in the risk of malignancy, with the exceptions of lymphoma and nonmelanoma skin cancers, with the use of TNF blockers. However, any risk may be unacceptable in a patient with a history or elevated risk of cancer. Ustekinumab acts on a different inflammatory pathway and may have a different profile regarding the risk of malignancy. A comprehensive review of the literature shows some consensus that relative contraindications are active malignancies and malignancies within the past 5 years. There is debate about nonmelanoma skin cancers and melanoma, but it seems prudent to use biologics more cautiously in a patient with a history of aggressive skin cancer, a high risk of recurrent skin cancer, or a history of extreme ultraviolet exposure. Additionally, certain combinations of immunosuppressive therapies, such as purine analogs, with biologics may lead to unacceptable risks of malignancy. Some subgroups, such as patients with chronic obstructive pulmonary disease, are already predisposed to lung cancer because of a significant smoking history; these patients require closer monitoring during biologic therapy. As the biologics are in use longer for psoriasis, more data on the long-term safety of these therapeutics will be available.

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Cervical cancer in a woman associated with long-term efalizumab therapy

Cited by 13 publications

References 4 publications

Hepatocellular carcinoma in a patient treated with efalizumab for psoriasis

Hepatocellular carcinoma in a patient treated with efalizumab for psoriasis

Alice, Eloi, Magali and Robert: the lives of four patients with psoriasis and the therapeutic approaches of eight European experts

Biologic Therapy and the Risk of Malignancy in Psoriasis

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