M Mateo-Casas1, S Reyes2, E A O'Toole3, S De Trane2, O Yildiz2, K Allen-Philbey4, J Mathews5, D Baker6, G Giovannoni2, K Schmierer7. 1. The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology, Hospital General Universitario de Castellón, Castellón de la Plana, Spain. 2. The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK. 3. The Blizard Institute (Cell Biology & Cutaneous Research), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK. 4. Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK. 5. Pathology and Pharmacy, The Royal London Hospital, Barts Health NHS Trust, London, UK. 6. The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK. 7. The Blizard Institute (Neuroscience, Surgery & Trauma), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK. Electronic address: k.schmierer@qmul.ac.uk.
Abstract
OBJECTIVE: To report three cases of severe skin reactions in patients treated with cladribine for multiple sclerosis. METHODS: Case study. RESULTS: Patients developed severe rash 3-192 days after receiving cladribine. All were effectively treated with steroids and antihistamines. Additional doses of cladribine were administered after pretreatment with steroids and anti-histamines. One patient developed mild recurrence following re-exposure, which resolved within three days, whilst another patient tolerated re-exposure without further adverse reaction. CONCLUSION: Severe skin reactions, well described in patients receiving cladribine for treatment of haematological conditions, may occur in patients treated with this compound for multiple sclerosis. Neurologists need to be aware of this rare, but significant adverse reaction. Re-exposure may be safe with standard pre-treatment against allergic reactions.
OBJECTIVE: To report three cases of severe skin reactions in patients treated with cladribine for multiple sclerosis. METHODS: Case study. RESULTS:Patients developed severe rash 3-192 days after receiving cladribine. All were effectively treated with steroids and antihistamines. Additional doses of cladribine were administered after pretreatment with steroids and anti-histamines. One patient developed mild recurrence following re-exposure, which resolved within three days, whilst another patient tolerated re-exposure without further adverse reaction. CONCLUSION: Severe skin reactions, well described in patients receiving cladribine for treatment of haematological conditions, may occur in patients treated with this compound for multiple sclerosis. Neurologists need to be aware of this rare, but significant adverse reaction. Re-exposure may be safe with standard pre-treatment against allergic reactions.
Authors: Leoni Rolfes; Steffen Pfeuffer; Jana Hackert; Marc Pawlitzki; Tobias Ruck; Wiebke Sondermann; Melanie Korsen; Heinz Wiendl; Sven G Meuth; Christoph Kleinschnitz; Refik Pul Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-04-09
Authors: Kimberley Allen-Philbey; Stefania De Trane; Zhifeng Mao; Cesar Álvarez-González; Joela Mathews; Amy MacDougall; Andrea Stennett; Xia Zhou; Ozlem Yildiz; Ashok Adams; Lucia Bianchi; Camilla Blain; Christine Chapman; Karen Chung; Cris S Constantinescu; Catherine Dalton; Rachel A Farrell; Leonora Fisniku; Helen Ford; Bruno Gran; Jeremy Hobart; Zhaleh Khaleeli; Miriam Mattoscio; Sue Pavitt; Owen Pearson; Luca Peruzzotti-Jametti; Antonio Scalfari; Basil Sharrack; Eli Silber; Emma C Tallantyre; Stewart Webb; Benjamin P Turner; Monica Marta; Sharmilee Gnanapavan; Gunnar Juliusson; Gavin Giovannoni; David Baker; Klaus Schmierer Journal: Ther Adv Neurol Disord Date: 2021-11-25 Impact factor: 6.570