@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 = "Winthrop, {K. L.} 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",
note = "Funding Information: K.W. received investigational grants and personal fees from Pfizer and BMS, as well as personal fees from Roche, Abbvie, UCB and Lilly. L.C. received personal fees from Abbvie, BMS, Jansen, GSK, Genentech, Norartis, Sanofi-Regeneron, Crescendo, UCB and Pfizer. J.S. received grants from Abbvie, Janssen, Lilly, MSD, Pfizer, Roche and Chugai, as well as personal fees from Abbvie, Amgen, Astra-Zeneca, Astro, BMS, Celgene, Celltrion, Chugai, Gilead, Glaxo, ILTOO, Janssen, Lilly, Medimmune, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi and UCB. J.M.A. received personal fees from Pfizer, Astellas and Merck. The remining authors declare no conflicts of interest (i.e. payment or services from a third party; relevant financial activities outside the submitted work; or patents planned, pending or issued broadly relevant to the sumitted work). Funding Information: This research was partially supported by Plan Nacional de I+D+I 2013–2016 and Instituto de Salud Carlos III , Subdirecci{\'o}n General de Redes y Centros de Investigaci{\'o}n Cooperativa , Spanish Ministry of Economy and Competitiveness , Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0002 and 0008)—co-financed by the European Development Regional Fund (EDRF) A way to achieve Europe. M.F.R. holds a clinical research contract {\textquoteleft}Juan Rod{\'e}s{\textquoteright} (JR14/00036) from the Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness. Funding Information: This research was partially supported by Plan Nacional de I+D+I 2013?2016 and Instituto de Salud Carlos III, Subdirecci?n General de Redes y Centros de Investigaci?n Cooperativa, Spanish Ministry of Economy and Competitiveness, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0002 and 0008)?co-financed by the European Development Regional Fund (EDRF) A way to achieve Europe. M.F.R. holds a clinical research contract ?Juan Rod?s? (JR14/00036) from the Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness.",
year = "2018",
month = jun,
doi = "10.1016/j.cmi.2018.02.002",
language = "English (US)",
volume = "24",
pages = "S21--S40",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier Limited",
}