Bär, Sarah; Räber, Irene; Koskinas, Konstantinos C; Schlapbach, Christoph; Räber, Lorenz (2022). Transient injection site reaction to alirocumab during immune system activation: a case series. European heart journal - case reports, 6(5), ytac187. Oxford University Press 10.1093/ehjcr/ytac187
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Background
Injection site reactions (ISRs) are known side effects of the proprotein convertase subtilisin kexin 9 (PCSK9) inhibitor alirocumab. Transient ISR to alirocumab after a long phase of good tolerability have not been reported previously.
Case summary
A 55-year-old woman (Patient 1) and a 77-year-old man (Patient 2) were treated with alirocumab for the management of dyslipidaemia. Both patients tolerated the treatment without side effects for 7 and 2 months, respectively. After an upper respiratory tract infection in Patient 1 and a first COVID-19 vaccination in Patient 2, both patients suddenly developed ISR with erythema, calor, and itching upon 2 (Patient 1) and 1 (Patient 2) subsequent injection(s), respectively. Symptoms resolved with local steroids, oral antihistamines, and cooling. After termination of the presumed immune system activated state, alirocumab was well tolerated again in both patients without recurrence of any ISR upon repeated applications.
Discussion
These are the first cases to report transient ISR to a PCSK9 inhibitor, possibly triggered by activation of the immune system, after prolonged good tolerability. Based on the transient and benign nature of the reaction, such patients should be encouraged to continue supervised treatment, as tolerability may return after resolution of the pro-inflammatory state.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Bär, Sarah, Koskinas, Konstantinos, Schlapbach, Christoph, Räber, Lorenz |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2514-2119 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
23 May 2022 09:45 |
Last Modified: |
05 Dec 2022 16:20 |
Publisher DOI: |
10.1093/ehjcr/ytac187 |
PubMed ID: |
35592747 |
Uncontrolled Keywords: |
Alirocumab Case report Inflammation Injection site reaction PCSK9 inhibitor |
BORIS DOI: |
10.48350/170155 |
URI: |
https://boris.unibe.ch/id/eprint/170155 |
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