Infectious Complications in Biologic and Targeted Therapies

Description

This book aims to approach the epidemiology, diagnosis and management of infectious complications related to the use of biologic and targeted therapies. The first part is a general overview on the epidemiology and prevention of infections with the use of these agents. Timelines, pre-treatment evaluation, use of vaccines and travel counseling. In the second part, we will analyze the specific risk of infections associated with the use of the most important agents. The third part approach the problem on a syndromic point of view. For example, how to evaluate pulmonary infiltrates in a patient receiving biologic agents. This part III includes the most difficult and conflicting syndromes that clinicians may face when evaluating these patients. This book is intended not only for infectious diseases specialists, but also for different medical specialties prescribing biologic and targeted therapies. Preface Contents Part I: Overview of the Epidemiology, Risk and Prevention of Infections 1: Overview of the Risk of Infection Associated with Biologic and Target Therapies Overview of Targeted and Biological Therapies Monoclonal Antibodies and Related Agents Small-Molecule Enzyme Inhibitors Assessment of the Risk of Infection References 2: Timeline and Infectious Disease Evaluation of Candidates to New Therapies Introduction Timeline of Infectious Complications in Patients on Biologic and Targeted Drugs Evaluation and Prevention of Infectious Complications in Patients on Biologic and Targeted Treatment Conclusion References 3: Safety and Efficacy of Vaccines in Patients on Targeted and Biologic Therapies Summary Table Evidence Summary by Medication Class TNF-Alpha Inhibitors and Abatacept Hepatitis B (HBV) Vaccine Pneumococcal Vaccine Influenza Vaccine Live Vaccines IL-1 Inhibitors IL-6 HBV Vaccine Pneumococcal Vaccine Influenza Tetanus Live Vaccines IL-12/23 IL-17 Eculizumab VEGF Inhibitors (Bevacizumab, Aflibercept) VEGF-R Inhibitors (Sorafenib, Sunitinib, Axitinib, Pazopanib, Regorafenib, Vandetanib, Cabozantinib, Ramucirumab) ErbB2/HER2 Inhibitors (Trastuzumab, Pertuzumab) ErbB Receptor Tyrosine Kinases (Erlotinib, Gefitinib, Afatinib, Osimertinib, Lapatinib, Neratinib) BCR-ABL Tyrosine Kinase Inhibitors (Imatinib, Dasatinib, Nilotinib, Bosutinib, Ponatinib) Burton Tyrosine Kinase Inhibitors (Ibrutinib, Acalabrutinib) PI3K Inhibitors Idelalisib, Buparlisib, Rigosertib, Duvelisib Janus Kinase Inhibitors (Ruxolitinib, Tofacitinib, Baricitinib) Pneumococcal Vaccine Influenza Tetanus Live Zoster Vaccine mTOR Inhibitors (Everolimus, Temsirolimus) Anti-CD20 (Rituximab, 90Y-Ibritumomab Tiuxetan, Ofatumumab, Ocrelizumab, Veltuzumab, 131I-Tositumomab, Obinutuzumab, Ocaratuzumab, Ublituximab) Pneumococcal Vaccine Influenza Hepatitis B Vaccine Tetanus Varicella Alemtuzumab Anti CD-38 (Daratumumab, Isatuxumab) CTLA-4 Inhibitors (Ipilimumab, Tremelimumab) PD-1 and PD-1 Ligand Inhibitors (Nivolumab, Pembrolizumab, Atezolizumab) Influenza Vaccine Recombinant Zoster Vaccine LFA-3 Inhibitor (Alefacept) Alpha 4-Integrin and LFA-1 Inhibitors (Natalizumab, Vedolizumab, Efalizumab) Influenza Vaccine Other Vaccines Live Vaccines Sphingosine 1-Phosphate Receptor Inhibitor (Fingolimod, Siponimod) Proteosome Inhibitors (Bortezomib, Carfilzomib, Ixazomib) References 4: Travel and Risk of Infections Introduction Infectious Diseases and Risks Factors for Travelers Modes of Transmission of Infections Risks Factors for Travelers Common Infectious Diseases in Travelers Gastrointestinal Infections Respiratory Infections Vector-Borne Infections Skin Infections Sexually Transmitted Infections Other Infections Fever in Travelers Health Tourism and Infectious Diseases Vaccine-Preventable Diseases and Vaccines Advice for Healthcare Workers to Give Travelers References Part II: Specific Agents and Risk of Infections 5: Anti-tumor Necrosis Factor-Alpha Agents Introduction Tumor Necrosis Factor-Alpha and the Innate Immune System Tumor Necrosis Factor-Alpha Inhibitors (TNFI) Risk of Infection Mycobacterial Infections Bacterial and Other Serious Infections Viral Infections Hepatitis B Hepatitis C Herpes Zoster Fungal Infections Pneumocystis Pneumonia Conclusion References 6: CD22, CD30, CD33, CD38, CD40, SLAMF-7 and CCR4 CD22-Targeted Agents: Epratuzumab, Inotuzumab Ozogamicin, Moxetumomab Pasudotox CD22 Antigen Mechanism of Action and Current Indications of Anti-CD22 Monoclonal Antibodies Clinical Evidence Risk of Infections and Its Management CD30-Targeted Agents: Brentuximab Vedotin CD30 Antigen Mechanism of Action and Current Indications for CD30 Monoclonal Antibodies Clinical Evidence Risk of Infections and Its Management CD33-Targeted Agents: Gemtuzumab Ozogamicin, Vadastuximab Talirine CD33 Antigen Mechanism of Action and Current Indications of Anti-CD33 Monoclonal Antibodies Clinical Evidence Risk of Infection and Its Management CD38-Targeted Agents: Daratumumab, Isatuximab CD38 Antigens Mechanism of Action and Current Indications of Anti-CD38 Monoclonal Antibodies Clinical Evidence Risk of Infection and Its Management CD40 Targeted Agents: Selicrelumab, Dacetuzumab, Lucatumumab CD40 Antigen Mechanism of Action, Approved Indications and Off-Labels Use of CD40 Monoclonal Antibodies Clinical Evidence Risk of Infections and Its Management CD319 (SLAMF7) Agents: Elotuzumab SLAMF7 (Previous CD139) Antigen Mechanism of Action, Approved Indications, and Off-Label Use of Anti-CD139 Monoclonal Antibodies Clinical Evidence Risk of Infections and Its Management CCR-4-Targeted Agents: Mogamulizumab Chemokine Receptor 4, CCR-4 Mechanism of Action, Approved Indications, and Off-Label Use of CCR-4 Monoclonal Antibodies Clinical Evidence Risk of Infection and Its Management References 7: CD19, CD20 and CD52 Introduction Anti-CD20 Agents Available Agents and Their Main Indications Mechanism of Action and the Pathogenesis of Increased Risk of Infectious Complications The Rates of Infectious Complications in Patients Treated with Anti-CD20 HBV Reactivation in Patients Treated with Anti-CD20 Agents Other Infectious Complications Hypogammaglobulinaemia and the Risk of Infections HGG and the Risk of Infections Hypogammaglobulinaemia (HGG) Management Neutropenia and the Risk of Infections CD19-Targeting Agents Available Agents Mechanism of Action and the Risk of Infectious Complications CD52-Targeting Agents Available Agents Mechanism of Action and the Risk of Infectious Complications Vaccination in Patients Receiving Anti-CD20, Anti-CD19 and Anti-CD52 Agents References 8: Cell-Surface Receptors: EGFR- and VEGFR-Targeted Agents Introduction Agents Targeting EGFR mAbs Against EGFR Mechanism of Action Approved Indications Expected Impact on Susceptibility to Infection Available Clinical Data Conclusions and Suggested Prevention Strategies EGFR-Targeted TKIs Mechanism of Action Approved Indications Expected Impact on Infection Risk Available Clinical Data Conclusions and Suggested Prevention Strategies Agents Targeting VEGF/VEGF Receptor (VEGFR) Intravenous Agents Targeting VEGF/VEGFR Mechanism of Action Approved Indications Expected Impact on Susceptibility to Infection Available Clinical Data Conclusions and Suggested Prevention Strategies TKIs Targeting VEGFR Mechanism of Action, Approved Indications, and Off-Label Use Expected Impact on Susceptibility to Infection Available Clinical Data Conclusions and Suggested Prevention Strategies References 9: Interleukin-1 Targeted Agents Introduction Available IL-1-Targeting Agents Infectious Complications of Interleukin-1 (IL-1)-Targeted Agents Anakinra Canakinumab Rilonacept Gevokizumab Tuberculosis Opportunistic Infections Conclusions References 10: Interleukin-6 Targeted Agents Introduction Mechanism of Action and Expected Impact on Infection Risk Available Clinical Data Conclusions and Suggested Prevention Strategies References 11: Interleukin-12 and -23 Targeted Agents Introduction: The Role of IL-12 and IL-23 in Immunity and Disease IL-12 and IL-23 as Therapeutic Targets Overall and Serious Infections IL-12-Targeted Agents IL-23-Targeted Agents Tuberculosis Other Opportunistic Infections Viral Hepatitis Hepatitis B Virus Hepatitis C Virus Recommendations for Infection Risk Management References 12: Sphingosine-1 Phosphate Receptor Modulators Biologic/Immune-Targeted Agent Mechanism of Action Current Indications for the Use The Described Risk of Infections References 13: Immune Checkpoint Inhibitors Introduction to Immune Checkpoint Blockade CTLA-4 Immune Checkpoint PD-1/PD-L1 Immune Checkpoint Brief History of Immune Checkpoint Inhibitors Mechanism of Action of Immune Checkpoint Inhibitors Indications CTLA-4 Inhibitors: Ipilimumab (Yervoy®) Tremelimumab PD-1 Inhibitors: Pembrolizumab (Keytruda®) Nivolumab (Opdivo®) Cemiplimab (Libtayo®) PD-L1 Inhibitors: Atezolizumab (Tecentriq®) Avelumab (Bavencio®) Durvalumab (Imfinzi®) Checkpoint Inhibitors and Infections Mechanisms Predisposing to Infection Risk of Infection Current Guidelines Using Checkpoint Inhibitors to Treat Infections Sepsis HIV JC Virus Hepatitis B Invasive Fungal Infections COVID-19 Mouse Models of Infection Summary References 14: α4-Integrin (and Other Leukocyte Integrin)-Targeting Agents Introduction Integrins Overview Integrins: A Complex Structure with Unique Biology Leukocyte Integrins Integrins as Therapeutic Targets Leukocyte-Integrin-Targeting Agents Monoclonal Antibodies: Mechanism of Action Other Therapeutic Agents Approved Indications of Integrin-Targeting Agents Natalizumab Vedolizumab Infectious Complications of Integrin-Targeting Agents Natalizumab Vedolizumab Efalizumab Prevention Strategies in MS Patients Receiving Natalizumab PML Risk Stratification JCV Serostatus and MRI Previous Immunosuppression Duration of Natalizumab Treatment Additional Biomarkers for Risk Stratification Additional Preventive Strategies Conclusions References 15: Tyrosine-Kinase Inhibitors Introduction The Tyrosine Kinase Inhibitor Family BCR-ABL Inhibitors Mechanism of Action (MOA) and Indications Risk of Infection Prevention of Infection Janus-Associated Kinases (JAK) Inhibitors MOA and Indication Risk of Infection Prevention of Infection Bruton’s Tyrosine Kinase (BTK) Inhibitors MOA and Indication Risk of Infection Prevention of Infection Phosphatidylinositol 3-Kinase (PI3K) Inhibitors MOA and Indication Risk of Infection Prevention of Infection Anaplastic Lymphoma Kinase (ALK) Inhibitors MOA and Indication Risk of Infection Prevention of Infection Spleen (Syk) TKI MOA and Indication Risk of Infection Prevention of Infection Conclusion References 16: Bcl-2, JAK and mTOR Inhibitors mTOR Inhibitors JAK Inhibitors BCL-2 Inhibitors References 17: Infection Associated with the Use of CAR T Cells Introduction Mechanism of Action of CAR T-Cell Therapy Main Toxicities Following CAR T-Cell Therapy CRS and ICANS Cytopenia Hypogammaglobulinemia Incidence of Infection Risk Factors for Infections Main Types of Infection Bacterial Infection Viral Infections Fungal Infections Latent Infections and Screening Strategies Prophylactic Regimens in Patients Receiving CAR T-Cell Therapy Vaccination Conclusions References Part III: Clinical Conditions Associated with the Use of Biologic and Targeted Therapies 18: Pulmonary Infiltrates Introduction Infectious Pulmonary Complications Bacterial Infections Mycobacterial Infections Respiratory Viruses Fungal Noninfectious Pulmonary Complications Interstitial Lung Disease Pleural Disease Pulmonary Nodules Drug-Induced Pulmonary Toxicity Practical Evaluation of Pulmonary Infiltrates Clinical History Investigations Blood Investigations Urine Investigations Respiratory Investigations Imaging Prevention References 19: Tuberculosis Introduction TNF-α Inhibitors Screening and Therapy of LTBI Non-anti-TNF Biologics and Other Targeted Immunomodulators IL-1 Inhibitors IL-6 Inhibitors IL-12/23 Inhibitors IL-17 Inhibitors T-Cell Co-stimulation Inhibitors B-Lymphocyte Depletion Therapy JAK Kinase Inhibitors References 20: Cytomegalovirus and Other Herpesviruses Introduction Cytomegalovirus and Immune Control of Infection Immune Control of Infection Biologic Drugs and Risk of Herpes Infection Tumor Necrosis Factor Alpha (TNF-α) Inhibitor Drugs: Adalimumab, Certolizumab, Etanercept, Golimumab, and Infliximab Drugs Targeting Specific B-Cell Receptors Anti-CD20: Obinutuzumab, Ocrelizumab, Ofatumumab, Rituximab, and Y-Ibritumomab Tiuxetan Anti-CD30: Brentuximab Vedotin Anti-CD38: Daratumumab Phosphatidylinositol 3-Kinase (PI3K) Inhibitors: Idelalisib, Buparlisib, Rigosertib, and Duvelisib Drugs Targeting T-Cell Activation IgG Against Cytotoxic T-Lymphocyte-Associated Protein 4: Blockade of CD28-CD80/86 Interaction by Abatacept and Belatacept Direct T-Cell Inhibitors Anti-CD52 Drugs: Alemtuzumab Interleukin-4, Interleukin-5, and Interleukin-6 Inhibitors Interleukin-4 Inhibitors: Dupilumab Interleukin-5 Inhibitors: Benralizumab, Mepolizumab, and Reslizumab Interleukin-6 Inhibitors: Tocilizumab, Sarilumab, and Siltuximab Checkpoint Inhibitors Agents Targeting Cytotoxic T-Lymphocyte-Associated Protein 4 (Ipilimumab and Tremelimumab) and Programmed Cell Death Protein-1 and Ligand-1 (Nivolumab, Pembrolizumab, and Atezolizumab) Tyrosine Kinase Inhibitors Used in Hematologic Malignancies BCR-ABL Tyrosine Kinase Inhibitor: Bosutinib, Dasatinib, Imatinib, Nilotinib, and Ponatinib Janus Kinase Inhibitors Ruxolitinib, Tofacitinib, and Baricitinib mTOR Inhibitors Everolimus, Sirolimus, and Temsirolimus Other Biologic Drugs Associated with the Risk of Herpesvirus Infections Sphingosine 1-Phosphate Receptor Modulator: Fingolimod Proteasome Inhibitors: Bortezomib, Carfilzomib, and Ixazomib CCR4 Inhibitors: Mogamulizumab Antiviral Prophylaxis Against Herpesvirus Infection Prophylaxis Against Herpes Simplex Virus and Varicella-Zoster Virus Cytomegalovirus References 21: Invasive Fungal Disease Introduction Invasive Candidiasis Clinical Presentation of Invasive Candidiasis Biologics and Targeted Therapies Associated with Increased Risk of Invasive Candidiasis TNF-α Inhibitors (E.G. Infliximab, Etanercept, Adalimumab, Certolizumab, Golimumab) Anti-IL-17 Agents (Secukinumab, Ixekizumab, Brodalumab) Other Agents with Reported Associations with Invasive Candidiasis Impact of Biologics and Targeted Therapies on Investigation, Treatment and Prophylaxis of Invasive Candidiasis Cryptococcosis Clinical Presentation of Cryptococcosis Biologics and Targeted Therapies Associated with Increased Risk of Cryptococcosis TNF-α Inhibitors Ibrutinib and Other Tyrosine Kinase Inhibitors Other Biologic and Targeted Therapies with Reported Associations with Cryptococcosis Impact of Biologics and Targeted Therapies on Investigation, Treatment and Prophylaxis of Cryptococcosis Invasive Mould Disease Clinical Presentation of Invasive Mould Disease Biologics and Targeted Therapies Associated with Increased Risk of Invasive Mould Disease BTK Inhibitors Other Agents with Reported Associations with Invasive Mould Disease Impact of Biologics and Targeted Therapies on Investigation, Treatment and Prophylaxis of Invasive Mould Disease Pneumocystis jirovecii Pneumonia Clinical Presentation of Pneumocystis jirovecii Pneumonia Biologics and Targeted Therapies Associated with Increased Risk of Pneumocystis jirovecii Pneumonia Anti-CD52 Therapy PI3K Inhibitors TNF-α Inhibitors BTK Inhibitors Other Agents with Reported Associations with PJP Impact of Biologics and Targeted Therapies on Investigation, Treatment and Prophylaxis of Pneumocystis jirovecii Pneumonia Other Invasive Fungal Diseases Including Endemic Mycoses Clinical Presentation of Endemic Mycoses Biologics and Targeted Therapies Associated with Increased Risk of Endemic Mycoses TNF-α Inhibitors (Infliximab, Etanercept, Adalimumab, Golimumab, Certolizumab) Other Agents with Reported Associations with Endemic Mycoses Impact of Biologics and Targeted Therapies on Investigation, Treatment and Prophylaxis of Endemic Mycoses Conclusion References 22: Progressive Multifocal Leukoencephalopathy Introduction PML Related with α4-Integrin-Targeted Agents Underlying Mechanisms of Natalizumab-Related PML Epidemiology and Risk Factors for Natalizumab-Related PML Clinical Features and Management Preventive Algorithms PML Related to Monoclonal Antibodies Against Lymphoma and Leukemia Surface Antigens Anti-CD20 Monoclonal Antibodies Antibodies Against Lymphoma and Leukemia Cell Surface Antigens Alemtuzumab Brentuximab Drugs Targeted to Intracellular Signaling Pathways References 23: Hepatitis Viruses Introduction Hepatitis B Hepatitis C B-Cell-Depleting Antibodies Anti-TNF-α Anti-IL-1R Antagonists Anti-IL-6/Anti-IL-6R Anti-IL-12/23 Anti-IL-17 Integrin Inhibitors JAK/STAT CTLA-4 Fusion Proteins CTLA-4 Inhibitors PD-1/PD-L1 Inhibitors Anti-CD52 Anti-CCR4 Summary References 24: Immune-Targeted Therapies for COVID-19 Introduction Immunomodulatory Agents for the Treatment of COVID-19 Interleukin-6 Antagonists Tocilizumab Siltuximab JAK/STAT Pathway Inhibitor Ruxolitinib Baricitinib Il-1 Antagonist Anakinra References Index