First case of <scp>DRESS</scp> (drug reaction with eosinophilia and systemic symptoms) associated with voxelotor

Lee, Matthew; Stringer, Thomas; Jacob, Jack; Friedman, Elana M; Minniti, Caterina P.; Billett, Henny H.; Curtis, Susanna A

doi:10.1002/ajh.26342

Cited by 5 publications

(2 citation statements)

References 11 publications

(18 reference statements)

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“…She was on epoetin alfa and required red blood cell transfusions every three months to treat symptomatic anemia. Prior to her voxelotor 1500mg once daily treatment, her hydroxyurea treatment was put on hold due to reticulocytopenia [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

“…Additionally, the patient laboratory test indicated a 2.5g/dL drop in hemoglobin levels, elevated WBC count at 13,900 mm3, eosinophilia at 5200 mm3, acute kidney injury with a creatinine of 3.96mg/dl, elevated bilirubin at 2.0 mg/dL and elevated liver enzymes (alkaline phosphatase-243, aspartate aminotransferase-129, alanine aminotransferase-82). The patient was diagnosed with voxelotor induced drug reaction with eosinophilia and systemic symptoms (DRESS) [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

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Comparing the Safety and Efficacy of L-Glutamine, Voxelotor, and Crizanlizumab for Reducing the Frequency of Vaso-Occlusive Crisis in Sickle Cell Disease: A Systematic Review

Dick¹,

Abdelgadir²,

Kulkarni³

et al. 2022

Cureus

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Sickle cell disease (SCD) is a group of inherited red blood cell disorders affecting millions worldwide. The median life expectancy of someone with SCD remains significantly low despite improvements in standards of care and the implementation of hydroxyurea therapy. Notably, a 20-year interval existed (after the implementation of hydroxyurea therapy) prior to the approval of other sickle cell medications, namely, l-glutamine, voxelotor, and crizanlizumab. In this systematic review, these new medications' impact on the occurrences of vaso-occlusive crisis (VOC) events were analyzed and the adverse events of each were noted. Further, a secondary analysis was conducted to determine the effect of combination therapies, whether synergistic, antagonistic, or additive. The systematic review was conducted following the PRISMA 2020 guidelines. The effect-based and dose-effect-based approaches were utilized to determine the combined drugs combination index based on the recommended dosage to achieve an efficacy of 50%. L-glutamine and crizanlizumab were effective in reducing the frequency of VOC (p= 0.0216 and p = 0.02). Voxelotor effect on the reduction of VOC occurrences was not significant, however, its effect on increasing hemoglobin levels was significant (p= <0.001). In all three therapies, pain was the most common adverse event reported by participants. The analysis of combination therapies revealed that voxelotor plus l-glutamine was synergistic, voxelotor plus crizanlizumab was antagonistic, and l-glutamine plus crizanlizumab was additive. Thus, voxelotor plus l-glutamine combination therapy may be more beneficial to sickle cell disease patients. As such, robust combination drug studies for approved therapies used in SCD should be initiated with a specific focus on voxelotor plus l-glutamine. Additionally, the development of medications that lessen the pain burden in sickle cell disease patients should also be prioritized.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%