Severe Raynaud Syndrome Induced by Adjuvant Interferon Alfa in Metastatic Melanoma

Husein‐ElAhmed, Husein; Callejas‐Rubio, José Luis; Olmo, Rosa Ortega del; Ríos-Fernández, Raquel; Ortego-Centeno, Norbérto

doi:10.3747/co.v17i4.519

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…RP is a known side effect of treatment with interferon supported by numerous cases reports [41,[108][109][110][111][112][113][114][115][116]. On direct questioning of patients taking IFN [117], symptoms of RP were reported by more than half.…”

Section: Drugs Increasing Blood Viscosity and Enhancing Vasoconstrictionmentioning

confidence: 99%

Drug‐induced Raynaud's phenomenon: beyond β‐adrenoceptor blockers

Khouri

Blaise

Carpentier

et al. 2016

Brit J Clinical Pharma

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AIMDrug-induced Raynaud's phenomenon (RP) has long been associated with the use of different drugs, including cancer chemotherapy or β-adrenoceptor blockers. However, sources report extremely variable prevalence and the level of evidence for each class is heterogeneous. Moreover, new signals are emerging from case reports and small series. Our objective was therefore to review available evidence about this adverse drug effect and to propose a mechanistic approach of drug-induced RP. METHODSA systematic review of English and French language articles was performed through Medline (1946Medline ( -2015 and Embase (1974Embase ( -2015. Further relevant papers were identified from the reference lists of retrieved articles. RESULTSWe identified 12 classes of drugs responsible for RP, with a variety of underlying mechanisms such as increased sympathetic activation, endothelial dysfunction, neurotoxicity or decreased red blood cell deformability. Cisplatin and bleomycin were associated with the highest risk, followed by β-adrenoceptor blockers. Recent data suggest a possible involvement of tyrosine kinase inhibitors (TKI), through an unknown mechanism. CONCLUSIONDrug-induced RP is a probably underestimated adverse drug event, with limited available evidence regarding its prevalence. Although rare, serious complications like critical digital ischaemia have been reported. When these treatments are started in patients with a history of RP, careful monitoring must be made and, if possible, alternative therapies that do not alter peripheral blood flow should be considered. IntroductionRaynaud's phenomenon (RP) is characterized by transient ischaemia of the extremities in response to environmental stress or emotions [1]. It typically manifests as changes to the fingers, with pallor (vasospasm and decreased blood flow), cyanosis (deoxygenation of the static venous blood) and rubor (reperfusion), often accompanied by pain. RP can be primary (i.e. idiopathic) or secondary to an underlying cause. In both cases, abnormalities of the cutaneous microcirculation are primarily involved in the pathophysiology of RP [2]. The prevalence of RP in the general population varies between 0.5 and 19%, with major geographic variability [3][4][5][6]. While primary RP is the most frequent form (80-90%) [7], RP may also be secondary to various auto-immune diseases (such as systemic sclerosis (SSc), systemic lupus erythematosus, vasculitis, etc.), or other systemic diseases [1]. Several drugs with peripheral vascular effects leading to decreased microvascular perfusion may induce or aggravate RP. Drug-induced RP probably goes unrecognized because of the limited knowledge of this side effect. British Journal of Clinical PharmacologyLiterature reviews and textbooks usually have comprehensively reviewed drugs that have long been known to be responsible for RP [8]. However, new signals are emerging from numerous case reports. Yet, to our knowledge, no systematic review has been performed and little is known about the prevalence and the level of evidence ...

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Section: Drugs Increasing Blood Viscosity and Enhancing Vasoconstrictionmentioning

confidence: 99%

Drug‐induced Raynaud's phenomenon: beyond β‐adrenoceptor blockers

Khouri

Blaise

Carpentier

et al. 2016

Brit J Clinical Pharma

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“…In systemic sclerosis (SSc)/scleroderma, it is with the highest frequency of approximately 95% [8]. RP could also be a sign in a spectrum of nonrheumatic pathology that also should be recognized and properly differentiated by the rheumatologists in routine clinical practice ( Table 1) [8][9][10][11][12][13][14].…”

Section: Classification Of Raynaud's Phenomenonmentioning

confidence: 99%

Raynaud’s Phenomenon

Lambova¹

2018

Newest Updates in Rheumatology

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Raynaud's phenomenon (RP) is a clinical consequence of recurrent vasospasm of the small arteries and arterioles of the fingers and toes provoked by cold and emotional stress. RP is classified into two categories, i.e., primary and secondary RP. Primary RP is an isolated finding in the absence of an underlying pathology, while secondary RP is a syndrome in the context of another disease. The patients with primary RP have a younger age at onset, sparing of the thumb, and benign course without development of digital ulcers. Contrarily, secondary RP is characterized with later age of onset above 30 years, thumb involvement, and more severe course with possible development of trophic changes. In these cases, a focused, complaint-directed history and physical examination aim to reveal clinical symptoms and findings that confirm the presence of an underlying disorder, e.g., connective tissue disease (CTD) or other pathology. Together with clinical examination, laboratory, immunological, and capillaroscopic assessments facilitate the internal differential diagnosis of secondary RP. The capillaroscopic examination should be performed in all patients with symptoms of RP even in those cases without signs of systemic rheumatic disease, because the abnormal capillaroscopic picture inherits a high positive predictive value for the development of CTD.

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Rheumatologic/Orthopedic Emergencies

Lü

Suarez‐Almazor

2016

Oncologic Emergencies

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Severe Raynaud Syndrome Induced by Adjuvant Interferon Alfa in Metastatic Melanoma

Cited by 3 publications

References 14 publications

Drug‐induced Raynaud's phenomenon: beyond β‐adrenoceptor blockers

Drug‐induced Raynaud's phenomenon: beyond β‐adrenoceptor blockers

Raynaud’s Phenomenon

Rheumatologic/Orthopedic Emergencies

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