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Dalal RS, Goksel B, Hamilton MJ. Excipient Exception: A Complication of Infliximab and Vedolizumab Infusions for Ulcerative Colitis. Dig Dis Sci 2023; 68:1709-1713. [PMID: 36929242 DOI: 10.1007/s10620-023-07866-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Rahul S Dalal
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Behiye Goksel
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Matthew J Hamilton
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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Pereckova J, Martiniakova S, Payer J, Falk M, Killinger Z, Perecko T. Analysis of hematological parameters in rheumatoid arthritis patients receiving biological therapy: contribution to prevention of avoidable hematological complications. EXCLI JOURNAL 2022; 21:580-594. [PMID: 35651659 PMCID: PMC9150010 DOI: 10.17179/excli2022-4702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/06/2022]
Abstract
Administration of biological therapy (BT) in rheumatoid arthritis (RA) patients is often associated with hematological complications, which result in switching among therapies. Thus, there is an instant need for suitable screening parameters that will help to individualize the therapy and minimize the onset of adverse effects. We analyzed the hematological profile of 99 RA patients receiving TNFα (Adalimumab - ADA, Golimumab - GOL, Etanercept - ETA) or IL-6 receptor (Tocilizumab - TCZ) inhibitors in order to find possible indicators to improve personalization of RA therapy. BTs significantly affect the levels of observed hematological parameters. In contrast to TNF-α inhibitors, TCZ normalized almost all monitored hematological parameters to values of healthy donors. Only GOL from the TNF-α inhibitors studied, was able to normalize neutrophil counts, as well as platelet indicators. Importantly, effects on the blood parameters (e.g. lymphocytes or platelet count) differ even within the same therapeutic group (anti-TNFα). Variable effects of individual biological agents in RA treatment point to importance to evaluate the patient's hematological profile to improve the selection of suitable BT. It will help to personalize the administration of BT and prevent unnecessary switching from an effective therapy just because of provocation of avoidable hematological complications.
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Affiliation(s)
- Jana Pereckova
- Center of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Bratislava, Slovak Republic,Department of Cell Biology and Radiobiology, Institute of Biophysics of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic
| | - Silvia Martiniakova
- Center of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Bratislava, Slovak Republic,Department of Food Technology, Faculty of Chemical and Food Technology, Slovak University of Technology, Bratislava, Slovak Republic
| | - Juraj Payer
- Comenius University Faculty of Medicine, 5th Department of Internal Medicine, University Hospital Bratislava, Bratislava, Slovak Republic
| | - Martin Falk
- Department of Cell Biology and Radiobiology, Institute of Biophysics of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic
| | - Zdenko Killinger
- Comenius University Faculty of Medicine, 5th Department of Internal Medicine, University Hospital Bratislava, Bratislava, Slovak Republic
| | - Tomas Perecko
- Center of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Bratislava, Slovak Republic,Department of Cell Biology and Radiobiology, Institute of Biophysics of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic,*To whom correspondence should be addressed: Tomas Perecko, Department of Cell Biology and Radiobiology, Institute of Biophysics of the Czech Academy of Sciences, v. v. i., Brno, Czech Republic; Tel.: 00420 723 285 231, E-mail:
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Šteňová E, Tarabčáková L, Babál P, Kašperová S. Hypereosinophilic syndrome-a rare adverse event of anti-cytokine treatment in rheumatoid arthritis resolved after Janus kinase inhibitor therapy. Clin Rheumatol 2020; 39:3507-3510. [PMID: 32495227 DOI: 10.1007/s10067-020-05134-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
Eosinophilia is uncommon in early rheumatoid arthritis (RA). The most frequent causes of hypereosinophilia during RA treatment are atopic eczema, allergy, helminth infection, haematological malignancy and drug-associated complications. The pathogenesis of this abnormality associated with anti-cytokine therapy is still unknown. We report the case of a young woman with RA and eosinophilia accompanied by systemic symptoms such as dyspnoea, fluid retention and eosinophilic vasculitis. An interesting observation was the persistence of eosinophilia during treatment with various biologics and its normalization after switching to the Janus kinase inhibitor baricitinib.
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Affiliation(s)
- Emőke Šteňová
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Staré Mesto, Mickiewiczova 13, 813 69, Bratislava, Slovakia.
| | - Lenka Tarabčáková
- Department of Rheumatology, Saint Michael's Hospital, Bratislava, Slovakia
| | - Pavel Babál
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Bratislava, Slovakia
| | - Stela Kašperová
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital Bratislava, Staré Mesto, Mickiewiczova 13, 813 69, Bratislava, Slovakia
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