RT Journal Article
SR Electronic
T1 CP-013 Etanercept on steroid-refractary acute Graft-Versus-Host disease
JF European Journal of Hospital Pharmacy
JO Eur J Hosp Pharm
FD British Medical Journal Publishing Group
SP A6
OP A6
DO 10.1136/ejhpharm-2015-000639.13
VO 22
IS Suppl 1
A1 González-Munguía, S
A1 Pérez León, M
A1 Piñero González, M
A1 Díaz-Pestano, M
A1 Molero Gómez, R
A1 Luzardo-Henríquez, H
YR 2015
UL http://ejhp.bmj.com/content/22/Suppl_1/A6.1.abstract
AB Background Allogeneic hematopoietic stem cell transplantation (HSCT) is the first-line treatment for many haematological diseases. Graft-versus-host disease (GVHD) is the major complication of HSCT.Steroids are the mainstay treatment of GVHD for reducing the systemic pro-inflammatory response. In about half of the patients, steroid treatment fails and they have to be treated with other immunosuppressant drugs. Of these, treatment with anti-TNF drugs such as etanercept is becoming an option for digestive manifestations of GVHD.Purpose To describe etanercept use and effectiveness in steroid-refractory acute graft-versus-host disease, after hematopoietic cell transplantation.Material and methods Patients treated with etanercept, an off-label use for steroid-refractory acute graft-versus-host disease, were selected and each patient’s medical history was reviewed to assess the clinical response.Results The study included 5 patients: 4 presented with digestive manifestations and one 1 presented pulmonary and liver manifestations. 4 patients showed a clinical response: 3 of them a partial response and 1 a total response.In 4 cases, etanercept 25 mg was administered twice a week with variable duration of treatment, achieving no response in 1 case (3 weeks), partial response in 2 cases (4 weeks and 8 weeks) and a complete response in 1 case (8 week period). Only one patient was treated with etanercept 50 mg administered twice a week for 5 weeks with a partial treatment response.Conclusion Previously published data estimated the response rates at about 60–62%, which was consistent with our results. These update the scarce bibliographic information about etanercept use in steroid-refractory acute graft-versus-host disease. Due to clinical design limitations and the small patient population, further clinical studies should be conducted to assess the efficacy and safety of etanercept in these patientsReferences and/or AcknowledgementsBusca A, Locatelli F, Marmont F, et al. Response to mycophenolate mofetil therapy in refractory chronic graft-versus-host disease. Haematologica 2003;88(7):837–9.References and/or AcknowledgementsNo conflict of interest.