Systematic review of BRAF/MEK inhibitors‐induced Severe Cutaneous Adverse Reactions (SCARs)

Torres‐Navarro, Ignacio; Unamuno‐Bustos, Blanca de; Botella‐Estrada, Rafael

doi:10.1111/jdv.16894

Cited by 29 publications

(33 citation statements)

References 71 publications

(129 reference statements)

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“…The present case highlights the importance of vemurafenib-induced DRESS syndrome, which is often characterized by early onset compared with DRESS syndrome induced by other medications (7-12 days compared with typically 2-6 weeks). Previous PD-1 inhibitor use is associated with more severe cutaneous toxicity from vemurafenib, 3 as our patient experienced (receiving pembrolizumab 4 days prior to vemurafenib).…”

Section: Discussionmentioning

confidence: 53%

“…Encorafenib shares the same sulfonamide moiety as the 2 aforementioned drugs, and whether it possesses similar antiinflammatory traits to dabrafenib is not known. Since the majority of patients with vemurafenibinduced DRESS syndrome are switched to dabrafenib, 3 we cannot conclude whether the lack of recurrence in our case depended on mere luck.…”

Section: Discussionmentioning

confidence: 76%

“…A recent systematic review showed, of 31 severe cutaneous adverse reactions to BRAF/MEK inhibitors, all were caused by vemurafenib except one (which was dabrafenib-caused). 3 It remains to be identified why vemurafenib is so disproportionately causative of DRESS syndrome compared with other BRAF/MEK inhibitors.…”

Section: Discussionmentioning

confidence: 99%

“…2 Subsequent publications demonstrate that severe cutaneous reactions to the combination of vemurafenib with cobimetinib occurs not infrequently: in a series of 68 patients receiving this combination, 16% developed DRESS. 3 Herein, we report a case of DRESS syndrome in a patient receiving vemurafenib and cobimetinib for metastatic melanoma. After recovery, she was successfully switched to encorafenib and binimetinib without recurrence after 6 months.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Successful transition to encorafenib following vemurafenib-induced drug rash with eosinophilia and systemic symptoms syndrome

2021

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Successful transition to encorafenib following vemurafenib-induced drug rash with eosinophilia and systemic symptoms syndrome

2021

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Serious Adverse Events of Oral and Topical Carbonic Anhydrase Inhibitors

et al. 2022

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laucoma is a progressive optic neuropathy that affects more than 60 million patients worldwide. 1 Carbonic anhydrase inhibitors (CAIs) decrease aqueous humor production, thus lowering intraocular pressure. 2 Topical CAIs are associated with a 20% intraocular pressure reduction, whereas oral CAIs are associated with a 30% intraocular pressure reduction. 3,4 When there are concerns about efficacy or patient adherence, oral CAIs are sometimes preferred over topical agents.Topical CAIs are often prescribed early in glaucoma treatment, whereas oral CAIs are reserved as a temporizing measure for acute, significant intraocular pressure elevation or for patients who are refractory to topical medications and laser trabeculoplasty. A reluctance to prescribe oral CAIs is attributed to the risk of life-threatening complications, systemic adverse events, and cross-reactivity in patients with a sulfonamide allergy. 2,[5][6][7][8][9] CAIs can cause systemic adverse reactions, including fatigue, paresthesias, nausea, dizziness, hypokalemia, kidney stones, and weight loss. 2,[9][10][11] Rare but serious complications include Stevens-Johnson syndrome (SJS), toxic-epidermal necrolysis (TEN), and aplastic anemia. The symptoms from CAIs have been described as intolerable, debilitating, serious, and sometimes worse than the disease itself. A prior report has noted that oral CAIs have fallen into disfavor because of the concern for serious adverse events. 9 The same reluctance is not found with topical CAIs. Some patients may not tolerate oral CAIs; however, the risk of serious adverse reactions is unclear. Given the paucity of evidence and the potential benefits, a critical analysis can support or refute prevailing concerns associated with oral CAIs. To examine the safety of CAIs in a universal health care system in Canada, we identified patients prescribed an oral CAI IMPORTANCE Some ophthalmologists may be reluctant to prescribe oral carbonic anhydrase inhibitors, given the potential for life-threatening systemic adverse reactions. OBJECTIVE To conduct a population-based analysis of the safety of oral or topical carbonic anhydrase inhibitors in clinical care. DESIGN, SETTING, AND PARTICIPANTSThis matched longitudinal cohort study took place in Ontario, Canada. Consecutive patients older than 65 years who were prescribed an oral or topical carbonic anhydrase inhibitor in Ontario, Canada, between January 1, 1995, and January 1, 2020, were identified. Patients were matched 1-to-1 based on age, sex, and diabetes status. Time zero was defined as the date of the first identified prescription for the medication, and the primary analysis focused on the first 120 days of follow-up. MAIN OUTCOMES AND MEASURESThe primary end point was a severe complicated adverse event of either Stevens-Johnson syndrome, toxic epidermal necrolysis, or aplastic anemia.RESULTS Overall, 128 942 matched patients initiated an oral or topical carbonic anhydrase inhibitor during the 25-year study period. The mean (SD) age was 75 (6.6) years, 71 958 (55.8%) were women...

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Dermatologic toxicities of targeted antineoplastic agents and immune checkpoint inhibitor therapy in pediatric patients: A systematic review

Liu

Teng

Spunt

et al. 2021

Pediatric Blood & Cancer

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Cutaneous adverse events (cAEs) from targeted antineoplastic agents and immune checkpoint inhibitors are common in children with cancer and may lead to dose reduction or cessation of critical oncologic treatment. Timely diagnosis and proper management of cAEs in pediatric oncology patients is essential to optimize ongoing cancerdirected therapy and improve quality of life. This systematic review of published studies summarizes dermatologic toxicities to targeted anticancer treatments and immune checkpoint inhibitors.

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Systematic review of BRAF/MEK inhibitors‐induced Severe Cutaneous Adverse Reactions (SCARs)

Cited by 29 publications

References 71 publications

Successful transition to encorafenib following vemurafenib-induced drug rash with eosinophilia and systemic symptoms syndrome

Successful transition to encorafenib following vemurafenib-induced drug rash with eosinophilia and systemic symptoms syndrome

Serious Adverse Events of Oral and Topical Carbonic Anhydrase Inhibitors

Dermatologic toxicities of targeted antineoplastic agents and immune checkpoint inhibitor therapy in pediatric patients: A systematic review

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