Tag Archives: neutropenia

Quick Hits: New Breast Cancer Drugs Have Fewer Side Effects, Antidepressant Use in Pregnancy and Autism & More

A new class of oral drugs for treating the most common type of breast cancer, known as cyclin-dependent kinase (CDK) inhibitors, appears to have fewer adverse events and side effects for most patients compared to other treatments. There are 2 CDK inhibitors currently on the market: Ibrance (palbociclib), approved in February 2015, and Kisqali (ribociclib), which was just approved in March. Both are used to treat hormone receptor-positive (HR+) metastatic breast cancer. A third CDK inhibitor, abemaciclib, is in late-stage development. Researchers examined all publicly available trials for the 3 drugs. The most common side effect was low white blood cells, a condition known as neutropenia that can lead to infection, though it was seen less in abemaciclib. However, neutropenia was usually temporary or resolved with a dose reduction. Other, more common side effects seen with the medications were diarrhea and fatigue. Less common side effects observed were nausea and alopecia (hair loss), though these were mild and treated through a dose reduction or a break from the drug. Posted July 14, 2017. Via The Oncologist.

Children exposed to antidepressants during pregnancy may have a slightly higher risk of developing autism than children of mothers with mental illness who didn’t receive the drugs. Researchers, however, stress that the absolute risk of autism was small, so the results should not be considered alarming. A team at the University of Bristol (UK) analyzed data from 254,610 individuals aged 4-17 of which 5,378 had autism. Of the 3,342 children exposed to antidepressants during pregnancy, 4.1% (136) had a diagnosis of autism compared with 2.9% (353) in 12,325 children not exposed to antidepressants whose mothers had a history of a psychiatric disorder. Researchers noted that overall, 95% of women who took antidepressants did not have a child with autism. An accompanying editorial noted that the results should not dissuade women with depression from using antidepressants in pregnancy since untreated depression can lead to “ substantial health consequences.” Posted July 19, 2017. Via The BMJ.

The FDA has approved a new hepatitis C (HCV) medication, Vosevi. The drug is actually a combination of two existing anti-viral treatments, sofosbuvir and velpatasvir (sold as Epclusa), and a new drug, voxilaprevir. Vosevi is for patients with HCV without liver disease (cirrhosis) or with a mild form of cirrhosis. Results from 2 late-stage trials demonstrated that 96-97% of patients who received Vosevi had no HCV detected in their blood 12 weeks after finishing treatment, an indication the infection has been cured. The most common side effects in patients taking Vosevi were headache, fatigue, diarrhea and nausea. Posted July 18, 2017. Via FDA.

 

High Blood Pressure Med May Increase Risk of Low White Blood Cell Count

A common drug used to treat high blood pressure may elevate the risk in some patients of a condition in which a person’s white blood cell count is severely diminished, leaving them more susceptible to infection.

A recent case study discussed in the American Journal of Case Reports described a 61-year-old man who went to the emergency room with severe throat pain and difficulty swallowing that lasted over a week. He said he was being treated for hypertension, and was taking Norvasc (amlodipine) and Lotensin (benazepril) for it.

At the hospital, the patient was diagnosed with neutropenia, an abnormally low level of neutrophils, a type of white blood cell. He was admitted and given antibiotics for the pharyngitis he also had.

Given that the patient started Lotensin 2 months before symptoms started, and neutropenia is rarely seen with Norvasc, doctors suspected Lotensin to be the cause of his drug-induced agranulocytosis (DIAG). After he was taken off Lotensin, the patient achieved a quick recovery in white blood cell count. And after 3 weeks, the patient’s white blood cell count remained in the normal range.

Drugs to treat cancer and antibiotics are the most common causes of DIAG, and there have been prior instances of trial subjects taking Lotensin, which is considered an ACE inhibitor, a common class of high blood pressure drugs, who developed the condition.

“Because [ACE inhibitors] are commonly employed drugs, we report this case to increase awareness among prescribers about this rare but potentially lethal side effect of benazepril,” the authors concluded.

New Psoriasis Med Demonstrates Efficacy, Safety Over Long Term

A new medication approved by the FDA in March to treat psoriasis has demonstrated sustained efficacy, even after the drug is taken for more than a year.

Taltz (ixekizumab), a biologic medication, was also found to be more effective than another popular biologic already on the market called Enbrel (etarnecept). Both medications are given by injection.

Taltz works by targeting a pathway in the immune system, called IL-17, known to promote psoriasis.

The latest findings, published in the New England Journal of Medicine, are based on results from 3 clinical trials that enrolled almost 4,000 people. In the first trial, Taltz was compared against a placebo. However, in the other two, it was compared against a placebo and Enbrel for the first 12 weeks, and then just placebo after 12 weeks.

After the first 12 weeks, the Taltz injection was given either once a month or every 12 weeks. After 60 weeks, nearly 75% of the patients given the biologic once a month had only a minimal amount of psoriasis, compared to just 7% of patients taking the placebo.

In addition, during the 12-week intial period of the studies, Taltz was more effective than Enbrel by a wide margin.

“Based on these findings, we expect that 80% of patients will have an extremely high response rate to ixekizumab, and about 40% will be completely cleared of psoriasis,” lead author Kenneth Gordon, MD, a professor of dermatology at Northwestern University Feinberg School of Medicine, said in a statement.

Like most medications, side effects were seen with some patients taking Taltz. These adverse events included slightly higher rates of low white blood cell count (neutropenia), yeast infection and inflammatory bowel disease compared to placebo. The safety of the biologic past 60 weeks of use is also not known.

Also, the research was funded by Eli Lilly, Taltz’s manufactuer. In addition, Gordon is a paid consultant for the drugmaker.