PMID- 32960413
OWN - NLM
STAT- MEDLINE
DCOM- 20210216
LR  - 20211020
IS  - 1179-6901 (Electronic)
IS  - 1174-5886 (Print)
IS  - 1174-5886 (Linking)
VI  - 20
IP  - 4
DP  - 2020 Dec
TI  - Systematic Review: Monoclonal Antibody-Induced Subacute Cutaneous Lupus 
      Erythematosus.
PG  - 319-330
LID - 10.1007/s40268-020-00320-5 [doi]
AB  - BACKGROUND: Subacute cutaneous lupus erythematosus (SCLE) lacks consensus 
      diagnostic criteria and the pathogenesis is poorly understood. There are 
      increasing reports of SCLE induced by monoclonal antibodies (mAbs), but there are 
      limited data on the aetiology, clinical characteristics and natural course of 
      this disease. METHODS: We devised a set of diagnostic criteria for SCLE in 
      collaboration with a multinational, multispecialty panel. This systematic review 
      employed a two-layered search strategy of five databases for cases of mAb-induced 
      SCLE (PROSPERO registered protocol CRD42019116521). To explore the relationship 
      between relative mAb use and the number of SCLE cases reported, the estimated 
      number of mAb users was modelled from 2013 to 2018 global commercial data and 
      estimated annual therapy costs. RESULTS: From 40 papers, we identified 52 cases 
      of mAb-induced SCLE, occurring in a cohort that was 73% female and with a median 
      age of 61 years. Fifty percent of cases were induced by anti-tumour necrosis 
      factor (TNF)-a agents. A median of three drug doses preceded SCLE onset and the 
      lesions lasted a median of 7 weeks after drug cessation. Oral and topical 
      corticosteroids were most frequently used. Of the licensed mAbs, adalimumab, 
      denosumab, rituximab, etanercept and infliximab were calculated to have the 
      highest relative number of yearly users based on global sales data. Comparing the 
      number of mAb-induced SCLE cases with estimated yearly users, the checkpoint 
      inhibitors pembrolizumab and nivolumab showed strikingly high rates of SCLE 
      relative to their global use, but ipilimumab did not. CONCLUSION: We present the 
      first systematic review characterising mAb-induced SCLE with respect to triggers, 
      clinical signs, laboratory findings, prognosis and treatment approaches. We 
      identify elevated rates associated with the use of checkpoint inhibitors and 
      anti-TNFa agents.
FAU - Bolton, Chrissy
AU  - Bolton C
AUID- ORCID: 0000-0003-0240-3244
AD  - University College London, University College London Hospitals NHS Foundation 
      Trust, London, UK. Christine.bolton@nhs.net.
AD  - Medical Sciences Division, University of Oxford, Oxford, UK. 
      Christine.bolton@nhs.net.
AD  - Translational Gastroenterology Unit, Experimental Medicine, University of Oxford, 
      John Radcliffe Hospital, Oxford, OX3 9DU, UK. Christine.bolton@nhs.net.
FAU - Chen, Yifan
AU  - Chen Y
AD  - Medical Sciences Division, University of Oxford, Oxford, UK.
FAU - Hawthorne, Rachel
AU  - Hawthorne R
AD  - John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.
FAU - Schepel, Ianthe R M
AU  - Schepel IRM
AD  - Medical Sciences Division, University of Oxford, Oxford, UK.
FAU - Harriss, Elinor
AU  - Harriss E
AD  - Bodleian Health Care Libraries, The Knowledge Centre, Oxford University Old Road 
      Campus Research Building, Oxford, UK.
FAU - Hofmann, Silke C
AU  - Hofmann SC
AD  - Department of Dermatology, Allergology and Dermatosurgery, HELIOS University 
      Hospital Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
FAU - Ellis, Spencer
AU  - Ellis S
AD  - Lister Hospital, East and North Herts NHS Trust, Stevenage, UK.
FAU - Clarke, Alexander
AU  - Clarke A
AD  - The Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
FAU - Wace, Helena
AU  - Wace H
AD  - Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, 
      Cambridge, UK.
FAU - Martin, Blanca
AU  - Martin B
AD  - Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' 
      Hospital, London, UK.
FAU - Smith, Joel
AU  - Smith J
AD  - Nuffield Department of Population Health, University of Oxford, Oxford, UK.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - New Zealand
TA  - Drugs R D
JT  - Drugs in R&D
JID - 100883647
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Antibodies, Monoclonal/*adverse effects/economics/therapeutic use
MH  - Humans
MH  - Immunologic Factors/*adverse effects/economics/therapeutic use
MH  - International Cooperation
MH  - Lupus Erythematosus, Cutaneous/*chemically induced/epidemiology/*therapy
MH  - Prognosis
MH  - Treatment Outcome
PMC - PMC7691410
COIS- Christine Bolton, Yifan Chen, Ianthe R.M Schepel, Elinor Harriss, Silke C. 
      Hofmann, Spencer Ellis, Alexander Clarke, Rachel Hawthorne, Helena Wace, Blanca 
      Martin, Joel Smith declare there are no conflicts of interest.
EDAT- 2020/09/23 06:00
MHDA- 2021/02/17 06:00
PMCR- 2020/09/22
CRDT- 2020/09/22 12:13
PHST- 2020/09/23 06:00 [pubmed]
PHST- 2021/02/17 06:00 [medline]
PHST- 2020/09/22 12:13 [entrez]
PHST- 2020/09/22 00:00 [pmc-release]
AID - 10.1007/s40268-020-00320-5 [pii]
AID - 320 [pii]
AID - 10.1007/s40268-020-00320-5 [doi]
PST - ppublish
SO  - Drugs R D. 2020 Dec;20(4):319-330. doi: 10.1007/s40268-020-00320-5.