Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/7106
Title: Interleukin (IL)-1/IL-6-Inhibitor-Associated Drug Reaction With Eosinophilia and Systemic Symptoms (DReSS) in Systemic Inflammatory Illnesses
Authors: Saper, Vivian E.
Tian, Lu
Verstegen, Ruud H. J.
Conrad, Carol K.
Cidon, Michal
Hopper, Rachel K.
Kuo, Christin S.
Osoegawa, Kazutoyo
Baszis, Kevin
Bingham, Catherine A.
Ferguson, Ian
Hahn, Timothy
Horne, Annacarin
Isupova, Eugenia A.
Jones, Jordan T.
Kasapcopur, Özgür
Klein-Gitelman, Marisa S.
Kostik, Mikhail M.
Ozen, Seza
Phadke, Omkar
Prahalad, Sampath
Randell, Rachel L.
Sener, Seher
Stingl, Cory
Abdul-Aziz, Rabheh
Akoghlanian, Shoghik
Al Julandani, Dalila
Alvarez, Marcela B.
Bader-Meunier, Brigitte
Balay-Dustrude, Erin E.
Balboni, Imelda
Baxter, Sarah K.
Berard, Roberta A.
Bhattad, Sagar
Bolaria, Roxana
Boneparth, Alexis
Cassidy, Elaine A.
Co, Dominic O.
Collins, Kathleen P.
Dancey, Paul
Dickinson, Aileen M.
Edelheit, Barbara S.
Espada, Graciela
Flanagan, Elaine R.
Imundo, Lisa F.
Jindal, Ankur K.
Kim, Hyoun-Ah
Klaus, Günter
Lake, Carol
Lapin, W. Blaine
Lawson, Erica F.
Marmor, Itay
Mombourquette, Joy
Ogunjimi, Benson
Olveda, Rebecca
Ombrello, Michael J.
Onel, Karen
Poholek, Catherine
Ramanan, Athimalaipet V.
Ravelli, Angelo
Reinhardt, Adam
Robinson, Amanda D.
Rouster-Stevens, Kelly
Saad, Nadine
Schneider, Rayfel
Selmanovic, Velma
Sefic Pasic, Irmina
Shenoi, Susan
Shilo, Natalie R.
Soep, Jennifer B.
Sura, Angeli
Taber, Sarah F.
Tesher, Melissa
Tibaldi, Jessica
Torok, Kathryn S.
Tsin, Cathy Mei
Vasquez-Canizares, Natalia
Villacis Nunez, Diana S.
Way, Emily E.
Whitehead, Benjamin
Zemel, Lawrence S.
Sharma, Surbhi
Fernández-Viña, Marcelo A.
Mellins, Elizabeth D.
Issue Date: 2024
Source: The journal of allergy and clinical immunology. In practice, 2024 (12) 11 p.2996
Pages: 2996
Journal Title: The journal of allergy and clinical immunology. In practice
Abstract: Background: After introducing IL-1/IL-6 inhibitors, some patients with Still and Still-like disease developed unusual, often fatal, pulmonary disease. This complication was associated with scoring as DReSS (drug reaction with eosinophilia and systemic symptoms) implicating these inhibitors, although DReSS can be difficult to recognize in the setting of systemic inflammatory disease.; Objective: To facilitate recognition of IL-1/IL-6 inhibitor-DReSS in systemic inflammatory illnesses (Still/Still-like) by looking at timing and reaction-associated features. We evaluated outcomes of stopping or not stopping IL-1/IL-6 inhibitors after DReSS reaction began.; Methods: In an international study collaborating primarily with pediatric specialists, we characterized features of 89 drug-reaction cases versus 773 drug-exposed controls and compared outcomes of 52 cases stopping IL-1/IL-6 inhibitors with 37 cases not stopping these drugs.; Results: Before the reaction began, drug-reaction cases and controls were clinically comparable, except for younger disease-onset age for reaction cases with preexisting cardiothoracic comorbidities. After the reaction began, increased rates of pulmonary complications and macrophage activation syndrome differentiated drug-reaction cases from drug-tolerant controls (P = 4.7 × 10 -35 and P = 1.1 × 10 -24 , respectively). The initial DReSS feature was typically reported 2 to 8 weeks after initiating IL-1/IL-6 inhibition. In drug-reaction cases stopping versus not stopping IL-1/IL-6-inhibitor treatment, reaction-related features were indistinguishable, including pulmonary complication rates (75% [39 of 52] vs 76% [28 of 37]). Those stopping subsequently required fewer medications for treatment of systemic inflammation, had decreased rates of macrophage activation syndrome, and improved survival (P = .005, multivariate regression). Resolution of pulmonary complications occurred in 67% (26 of 39) of drug-reaction cases who stopped and in none who continued inhibitors.; Conclusions: In systemic inflammatory illnesses, recognition of IL-1/IL-6-inhibitor-associated reactions followed by avoidance of IL-1/IL-6 inhibitors significantly improved outcomes. (Copyright © 2024 American Academy of Allergy, Asthma & Immunology. All rights reserved.)
DOI: 10.1016/j.jaip.2024.07.002
Resources: https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,athens&db=mdc&AN=39002722&site=ehost-live
Appears in Sites:Children's Health Queensland Publications
Queensland Health Publications

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