Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update

Zembiec-Wheeler, Bethany; Lott-Limbach, Abberly A.; Malmström, Hans; Sharon, Elad

doi:10.1016/j.oooo.2018.06.009

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…On the other hand, a 43-year-old woman with follicular lymphoma was treated with rituximab and developed OLR [115]. A 68-year-old woman also developed OLR with oral pain caused by abatacept on treating rheumatoid arthritis [116]. Abatacept is CTLA-4-Ig that binds CD80/86 on DC and blocks the co-stimulatory signal through CD28 of T cells, which suppresses T cell-mediated inflammation of rheumatoid arthritis.…”

Section: Induction Of Oral Mucosal Lesions By Icismentioning

confidence: 99%

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Yura

Hamada

2022

Cancers

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Conventional chemotherapy and targeted therapies have limited efficacy against advanced head and neck squamous cell carcinoma (HNSCC). The immune checkpoint inhibitors (ICIs) such as antibodies against CTLA-4, PD-1, and PD-L1 interrupt the co-inhibitory pathway of T cells and enhance the ability of CD8+ T cells to destroy tumors. Even in advanced HNSCC patients with recurrent diseases and distant metastasis, ICI therapy shows efficiency and become an effective alternative to conventional chemotherapy. However, as this therapy releases the immune tolerance state, cytotoxic CD8+ T cells can also attack organs and tissues expressing self-antigens that cross-react with tumor antigens and induce immune-related adverse events (irAEs). When patients with HNSCC are treated with ICIs, autoimmune diseases occur in multiple organs including the skin, digestive tract, endocrine system, liver, and respiratory tract. Treatment of various malignancies, including HNSCC, with ICIs may result in the appearance of oral irAEs. In the oral cavity, an oral lichenoid reaction (OLR) and pemphigoid develop. Sicca syndrome also occurs in association with ICIs, affecting the salivary glands to induce xerostomia. It is necessary to elucidate the pathogenic mechanisms of these intractable diseases that are not seen with conventional therapy. Early diagnosis and appropriate approaches to irAEs are needed for efficient treatment of advanced HNSCC by ICIs.

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Section: Induction Of Oral Mucosal Lesions By Icismentioning

confidence: 99%

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Yura

Hamada

2022

Cancers

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“…There are many HSRs due to various biological agents reported in the literature. Abatacept-induced neutrophilic dermatosis (Sweet's syndrome), atopic dermatitis exacerbations, lichenoid and psoriasiform reactions, and asthma attacks have been reported (8)(9)(10)(11)(12)(13). However, abatacept-induced HSRs and other immune reactions are rarely observed (1,14).…”

Section: Introductionmentioning

confidence: 99%

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Bilgir¹,

Kabadayi²,

Akar³

2021

Asthma Allergy Immunol

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Abatacept is a fusion protein that blocks T cell activation. It is used in a variety of conditions including organ transplantation, immune deficiency, and autoimmune diseases. Even though abatacept-induced adverse events are observed, hypersensitivity reactions are rare. Desensitization protocols that can be implemented in the case of hypersensitivity reactions are present in the literature for many biological agents. However, a desensitization protocol for abatacept has not yet been established. Our patient, who was started on one of the biological agents, abatacept, for rheumatoid arthritis due to insufficient response to disease- modifying antirheumatic drugs, developed immediate hypersensitivity reaction with the first dose. Since it was planned to continue the treatment, abatacept desensitization was performed. The rapid desensitization protocol performed with prior premedication was successful and the patient was able to receive subsequent doses of abatacept using the same protocol. Keywords: Abatacept, anaphylaxis, desensitization

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Abatacept

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Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update

Cited by 5 publications

References 29 publications

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Abatacept

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