ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: An infectious diseases perspective (Soluble immune effector molecules [II]: Agents targeting interleukins, immunoglobulins and complement factors)

Kevin Winthrop, X. Mariette, J. T. Silva, E. Benamu, L. H. Calabrese, A. Dumusc, J. S. Smolen, J. M. Aguado, M. Fernández-Ruiz

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Abstract

Background: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. Aims: To review, from an Infectious Diseases perspective, the safety profile of agents targeting interleukins, immunoglobulins and complement factors and to suggest preventive recommendations. Sources: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family. Content: Patients receiving interleukin-1 (IL-1) -targeted (anakinra, canakinumab or rilonacept) or IL-5-targeted (mepolizumab) agents have a moderate risk of infection and no specific prevention strategies are recommended. The use of IL-6/IL-6 receptor-targeted agents (tocilizumab and siltuximab) is associated with a risk increase similar to that observed with anti-tumour necrosis factor-α agents. IL-12/23-targeted agents (ustekinumab) do not seem to pose a meaningful risk of infection, although screening for latent tuberculosis infection may be considered and antiviral prophylaxis should be given to hepatitis B surface antigen-positive patients. Therapy with IL-17-targeted agents (secukinumab, brodalumab and ixekizumab) may result in the development of mild-to-moderate mucocutaneous candidiasis. Pre-treatment screening for Strongyloides stercoralis and other geohelminths should be considered in patients who come from areas where these are endemic who are receiving IgE-targeted agents (omalizumab). C5-targeted agents (eculizumab) are associated with a markedly increased risk of infection due to encapsulated bacteria, particularly Neisseria spp. Meningococcal vaccination and chemoprophylaxis must be administered 2-4 weeks before initiating eculizumab. Patients with high-risk behaviours and their partners should also be screened for gonococcal infection. Implications: Preventive strategies are particularly encouraged to minimize the occurrence of neisserial infection associated with eculizumab.

Original languageEnglish (US)
JournalClinical Microbiology and Infection
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Biological Therapy
Interleukins
Communicable Diseases
Immunoglobulins
Consensus
Safety
Infection
LY2439821
Strongyloides stercoralis
Interleukin 1 Receptor Antagonist Protein
Neisseria
Latent Tuberculosis
Interleukin-23
Interleukin-6 Receptors
Interleukin-17
Candidiasis
Interleukin-5
Chemoprevention
Interleukin-12
Hepatitis B Surface Antigens

Keywords

  • Anakinra
  • Brodalumab
  • Canakinumab
  • Eculizumab
  • Infection
  • Ixekizumab
  • Prevention
  • Rilonacept
  • Secukinumab
  • Tocilizumab

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{0b813820e36a4919831aede995d34d5f,
title = "ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: An infectious diseases perspective (Soluble immune effector molecules [II]: Agents targeting interleukins, immunoglobulins and complement factors)",
abstract = "Background: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. Aims: To review, from an Infectious Diseases perspective, the safety profile of agents targeting interleukins, immunoglobulins and complement factors and to suggest preventive recommendations. Sources: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family. Content: Patients receiving interleukin-1 (IL-1) -targeted (anakinra, canakinumab or rilonacept) or IL-5-targeted (mepolizumab) agents have a moderate risk of infection and no specific prevention strategies are recommended. The use of IL-6/IL-6 receptor-targeted agents (tocilizumab and siltuximab) is associated with a risk increase similar to that observed with anti-tumour necrosis factor-α agents. IL-12/23-targeted agents (ustekinumab) do not seem to pose a meaningful risk of infection, although screening for latent tuberculosis infection may be considered and antiviral prophylaxis should be given to hepatitis B surface antigen-positive patients. Therapy with IL-17-targeted agents (secukinumab, brodalumab and ixekizumab) may result in the development of mild-to-moderate mucocutaneous candidiasis. Pre-treatment screening for Strongyloides stercoralis and other geohelminths should be considered in patients who come from areas where these are endemic who are receiving IgE-targeted agents (omalizumab). C5-targeted agents (eculizumab) are associated with a markedly increased risk of infection due to encapsulated bacteria, particularly Neisseria spp. Meningococcal vaccination and chemoprophylaxis must be administered 2-4 weeks before initiating eculizumab. Patients with high-risk behaviours and their partners should also be screened for gonococcal infection. Implications: Preventive strategies are particularly encouraged to minimize the occurrence of neisserial infection associated with eculizumab.",
keywords = "Anakinra, Brodalumab, Canakinumab, Eculizumab, Infection, Ixekizumab, Prevention, Rilonacept, Secukinumab, Tocilizumab",
author = "Kevin Winthrop and X. Mariette and Silva, {J. T.} and E. Benamu and Calabrese, {L. H.} and A. Dumusc and Smolen, {J. S.} and Aguado, {J. M.} and M. Fern{\'a}ndez-Ruiz",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.cmi.2018.02.002",
language = "English (US)",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
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TY - JOUR

T1 - ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies

T2 - An infectious diseases perspective (Soluble immune effector molecules [II]: Agents targeting interleukins, immunoglobulins and complement factors)

AU - Winthrop, Kevin

AU - Mariette, X.

AU - Silva, J. T.

AU - Benamu, E.

AU - Calabrese, L. H.

AU - Dumusc, A.

AU - Smolen, J. S.

AU - Aguado, J. M.

AU - Fernández-Ruiz, M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. Aims: To review, from an Infectious Diseases perspective, the safety profile of agents targeting interleukins, immunoglobulins and complement factors and to suggest preventive recommendations. Sources: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family. Content: Patients receiving interleukin-1 (IL-1) -targeted (anakinra, canakinumab or rilonacept) or IL-5-targeted (mepolizumab) agents have a moderate risk of infection and no specific prevention strategies are recommended. The use of IL-6/IL-6 receptor-targeted agents (tocilizumab and siltuximab) is associated with a risk increase similar to that observed with anti-tumour necrosis factor-α agents. IL-12/23-targeted agents (ustekinumab) do not seem to pose a meaningful risk of infection, although screening for latent tuberculosis infection may be considered and antiviral prophylaxis should be given to hepatitis B surface antigen-positive patients. Therapy with IL-17-targeted agents (secukinumab, brodalumab and ixekizumab) may result in the development of mild-to-moderate mucocutaneous candidiasis. Pre-treatment screening for Strongyloides stercoralis and other geohelminths should be considered in patients who come from areas where these are endemic who are receiving IgE-targeted agents (omalizumab). C5-targeted agents (eculizumab) are associated with a markedly increased risk of infection due to encapsulated bacteria, particularly Neisseria spp. Meningococcal vaccination and chemoprophylaxis must be administered 2-4 weeks before initiating eculizumab. Patients with high-risk behaviours and their partners should also be screened for gonococcal infection. Implications: Preventive strategies are particularly encouraged to minimize the occurrence of neisserial infection associated with eculizumab.

AB - Background: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. Aims: To review, from an Infectious Diseases perspective, the safety profile of agents targeting interleukins, immunoglobulins and complement factors and to suggest preventive recommendations. Sources: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family. Content: Patients receiving interleukin-1 (IL-1) -targeted (anakinra, canakinumab or rilonacept) or IL-5-targeted (mepolizumab) agents have a moderate risk of infection and no specific prevention strategies are recommended. The use of IL-6/IL-6 receptor-targeted agents (tocilizumab and siltuximab) is associated with a risk increase similar to that observed with anti-tumour necrosis factor-α agents. IL-12/23-targeted agents (ustekinumab) do not seem to pose a meaningful risk of infection, although screening for latent tuberculosis infection may be considered and antiviral prophylaxis should be given to hepatitis B surface antigen-positive patients. Therapy with IL-17-targeted agents (secukinumab, brodalumab and ixekizumab) may result in the development of mild-to-moderate mucocutaneous candidiasis. Pre-treatment screening for Strongyloides stercoralis and other geohelminths should be considered in patients who come from areas where these are endemic who are receiving IgE-targeted agents (omalizumab). C5-targeted agents (eculizumab) are associated with a markedly increased risk of infection due to encapsulated bacteria, particularly Neisseria spp. Meningococcal vaccination and chemoprophylaxis must be administered 2-4 weeks before initiating eculizumab. Patients with high-risk behaviours and their partners should also be screened for gonococcal infection. Implications: Preventive strategies are particularly encouraged to minimize the occurrence of neisserial infection associated with eculizumab.

KW - Anakinra

KW - Brodalumab

KW - Canakinumab

KW - Eculizumab

KW - Infection

KW - Ixekizumab

KW - Prevention

KW - Rilonacept

KW - Secukinumab

KW - Tocilizumab

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U2 - 10.1016/j.cmi.2018.02.002

DO - 10.1016/j.cmi.2018.02.002

M3 - Article

C2 - 29447987

AN - SCOPUS:85043269426

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

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