Hematologic side effects of biologics and kinase inhibitors used in rheumatologic diseases: a review of the current evidence

Bhandari, Sambhawana; Baral, Maun Ranjan; Barbery, Matthew; Rudinskaya, Alla; Sostin, Oleg

doi:10.1007/s00277-022-04896-7

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…RA treatment involves the use of drugs which can alter in many ways the profile of the patient’s blood test ( 110 ).…”

Section: Resultsmentioning

confidence: 99%

Rational approach to the prescription of anti-rheumatic drugs in rheumatoid arthritis: a product leaflet-based strategy in Italy

Perricone,

Castellucci,

Cafaro

et al. 2024

Front. Immunol.

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The treatment of patients with rheumatoid arthritis (RA) has dramatically changed in the past 30 years. Currently, numerous conventional, biologic, and targeted synthetic DMARDs have been licensed and used following recommendations provided by international and national scientific societies. However, the availability of biosimilars and the increasing necessity of savings impacted on the local/national prescription of these drugs. The information provided by data sheet of every single drug is a decisive factor on the choice of a certain treatment merged with the patient’s profile. Thus, our purpose was to construct a rational algorithm for the treatment strategy in RA according to costs and the product leaflet of the biologic and targeted-synthetic DMARDs currently licensed in Italy. We used the most recent available recommendations and then we performed a review of the literature considering all the factors that are known to influence drug safety/effectiveness. All these factors were considered in the context of the data sheets of currently available originators and biosimilars.

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“…RA treatment involves the use of drugs which can alter in many ways the profile of the patient’s blood test ( 110 ).…”

Section: Resultsmentioning

confidence: 99%

Rational approach to the prescription of anti-rheumatic drugs in rheumatoid arthritis: a product leaflet-based strategy in Italy

Perricone,

Castellucci,

Cafaro

et al. 2024

Front. Immunol.

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“…This inhibition could potentially create an environment conducive to mycobacterial proliferation. Additionally, TNFi may disrupt the activation of macrophages and the formation of phagosomes, which are critical for eliminating intracellular pathogens like NTM [46] and increase susceptibility to opportunistic infections caused by neutropenia [47]. All these mechanisms offer potential insights into the complex interplay between TNFi usage and the risk of NTM infection in RA patients.…”

Section: Discussionmentioning

confidence: 99%

Association of Tumor Necrosis Factor Inhibitors with the Risk of Nontuberculous Mycobacterial Infection in Patients with Rheumatoid Arthritis: A Nationwide Cohort Study

Park,

Choi,

Song

et al. 2023

JCM

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Tumor necrosis factor inhibitors (TNFi) are proposed as a risk factor for nontuberculous mycobacteria (NTM) infection. Limited research investigates NTM infection risk in rheumatoid arthritis (RA) patients treated with TNFi compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), considering other concurrent or prior non-TNFi antirheumatic drugs. We aimed to evaluate the NTM infection risk associated with TNFi using a real-world database. Patients with RA treated with TNFi or csDMARDs between 2005 and 2016 were identified utilizing the Korean National Health Insurance Service database. To minimize potential bias, we aligned the initiation year of csDMARDs for both TNFi and csDMARD users and tracked them from their respective treatment start dates. The association of TNFi with NTM infection risk was estimated in a one-to-one matched cohort using a multivariable conditional Cox regression analysis. In the matched cohort (n = 4556), the incidence rates of NTM infection were 2.47 and 3.66 per 1000 person-year in TNFi and csDMARD users. Compared to csDMARDs, TNFi did not increase the risk of NTM infection (adjusted hazard ratio (aHR) 0.517 (95% confidence interval, 0.205–1.301)). The TNFi use in RA patients was not associated with an increased risk of NTM infection compared to csDMARDs. Nevertheless, monitoring during TNFi treatment is crucial.

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Autoimmune Hemolytic Anemia From Tofacitinib Use in a Patient With Ulcerative Colitis

Zisman,

Bashir-Hamidu,

George

2024

ACG Case Rep J

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Tofacitinib is a Janus kinase inhibitor commonly used in the management of rheumatoid arthritis and moderate-to-severe ulcerative colitis. Anemia is a rare side effect of this medication often with minimal changes in hemoglobin levels. We report the first case of autoimmune hemolytic anemia from tofacitinib use in a patient with inflammatory bowel disease. This patient developed transfusion-dependent anemia after the initiation of tofacitinib and underwent extensive workup that revealed a diagnosis of autoimmune hemolytic anemia. The medication was discontinued, and she was treated with steroids and rituximab, leading to the improvement and stabilization of her hemoglobin levels.

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Hematologic side effects of biologics and kinase inhibitors used in rheumatologic diseases: a review of the current evidence

Cited by 3 publications

References 55 publications

Rational approach to the prescription of anti-rheumatic drugs in rheumatoid arthritis: a product leaflet-based strategy in Italy

Rational approach to the prescription of anti-rheumatic drugs in rheumatoid arthritis: a product leaflet-based strategy in Italy

Association of Tumor Necrosis Factor Inhibitors with the Risk of Nontuberculous Mycobacterial Infection in Patients with Rheumatoid Arthritis: A Nationwide Cohort Study

Autoimmune Hemolytic Anemia From Tofacitinib Use in a Patient With Ulcerative Colitis

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