Adalimumab for Sintilimab-Induced Toxic Epidermal Necrolysis in a Patient with Metastatic Gastric Malignancy: A Case Report and Literature Review
Open Access
- 1 February 2023
- journal article
- review article
- Published by Taylor & Francis Ltd in Clinical, Cosmetic and Investigational Dermatology
- Vol. ume 16, 457-461
- https://doi.org/10.2147/ccid.s401286
Abstract
Sintilimab is a recombinant fully human anti-programmed cell death protein 1 (PD-1) monoclonal antibody that blocks the interaction of PD-1 with its ligand. It was approved to use in patients with gastric malignancy. Toxic epidermal necrolysis (TEN) is a rare, life-threatening cutaneous drug reaction. Here, we report a 70-year-old female patient with gastric malignancy who developed severe TEN 10 days after initiation of sintilimab. The patient did not respond to the systemic corticosteroids and intravenous immunoglobulin therapies but improved after the subcutaneous injection of adalimumab (40 mg) that is a monoclonal antibody directed against antitumor necrosis factor-α. Her rashes rapidly resolved within 24 hr. By the seventh day, the bullae had scabbed and most skin lesions had subsided. The patient showed no sign of organ dysfunction. This is the first reported case of immune checkpoint inhibitor-induced TEN successfully treated with adalimumab.Keywords
This publication has 17 references indexed in Scilit:
- Nivolumab-Induced Toxic Epidermal Necrolysis: Rare but Fatal Complication of Immune Checkpoint Inhibitor TherapyCureus, 2021
- Comparison of anti-TNF and IL-inhibitors treatments in patients with psoriasis in terms of response to routine laboratory parameter dynamicsJournal of Dermatological Treatment, 2020
- Toxic Epidermal Necrolysis and Steven–Johnson Syndrome: A Comprehensive ReviewAdvances in Wound Care, 2020
- Immune checkpoint inhibitor–related dermatologic adverse eventsJournal of the American Academy of Dermatology, 2020
- Clinical and pathogenic aspects of the severe cutaneous adverse reaction epidermal necrolysis (EN)Journal of the European Academy of Dermatology and Venereology, 2020
- Management of immune checkpoint inhibitor‐related dermatologic adverse eventsThoracic Cancer, 2019
- Combination Therapy of Ipilimumab and Nivolumab-associated Toxic Epidermal Necrolysis (TEN) in a Patient With Metastatic Melanoma: A Case Report and Literature ReviewJournal of Immunotherapy, 2019
- Toxic epidermal necrolysis (TEN) associated with the use of nivolumab (PD-1 inhibitor) for lymphomaJAAD Case Reports, 2018
- Epidermal programmed cell death‐ligand 1 expression in TEN associated with nivolumab therapyJournal of Cutaneous Pathology, 2017
- Delayed reactions to drugs show levels of perforin, granzyme B, and Fas-L to be related to disease severityJournal of Allergy and Clinical Immunology, 2002