Ocular Side Effects of EGFR-Inhibitor ABT-414 in Recurrent Glioblastoma: A Long-Term Safety Study

ABSTRACT Steroids are a group of anti-inflammatory drugs, commonly used to treat ocular and systemic conditions. Unmonitored use of steroids especially in eye drop formulations is common in situations when it is easily available over-the-counter, resulting in undesirable side effects. Among the ocular side effects, cataract and glaucoma are common. Steroid-induced ocular hypertension was reported in 1950, when long-term use of systemic steroid was shown to increase the intraocular pressure (IOP). Chronic administration of steroids in any form with raised IOP can cause optic neuropathy resulting in steroid-induced glaucoma. This review describes the pathophysiology and epidemiology of steroid-induced glaucoma, recognition of side effects, and principles of management. The purpose is to familiarize all clinicians with the potential dangers of administering steroids without monitoring the eye and the dangers of irreversible blindness in some instances of habitual self-prescription by patients. How to cite this article Phulke S, Kaushik S, Kaur S, Pandav SS. Steroid-induced Glaucoma: An Avoidable Irreversible Blindness. J Curr Glaucoma Pract 2017;11(2):67-72.

Download Full-text

What can visual caregivers expect with patients treated for SARS-CoV-2? An analysis of ongoing clinical trials and ocular side effects

European Journal of Ophthalmology ◽

10.1177/1120672120958323 ◽

2020 ◽

pp. 112067212095832

Author(s):

Isabel Fambuena-Muedra ◽

Marta Jiménez-García ◽

Sarah Hershko ◽

Irene Altemir-Gómez ◽

Ana Tobarra-López

Keyword(s):

Clinical Trials ◽

Side Effects ◽

Exclusion Criterion ◽

Ophthalmological Examination ◽

Ocular Side ◽

Short Period ◽

Repurposed Drugs ◽

Detailed Search ◽

Ocular Side Effect

Within the COVID-19 pandemic context, the WHO has proposed a list of medicines to treat patients with severe acute respiratory syndrome (SARS-CoV-2). An analysis of their ocular side effects was performed. Only chloroquine and hydroxychloroquine were found to have an ocular impact in the medium and long-term. Detailed search strategies were performed in EMBASE, MEDLINE, SCOPUS and WOS Core Collection. Additionally, the worldwide ongoing clinical trials including chloroquine or hydroxychloroquine were evaluated, and their proposals of drug administration and exclusion criteria analyzed. In general, high maximum cumulative doses of chloroquine or hydroxychloroquine are being used for a short period in 135 currently underway clinical trials (to 21st April 2020). Typically, the doses were 2 to 5 times greater than the AAO recommendation (adjusted to weight) to avoid toxic retinopathy, the most undesirable ocular side effect. Maximum cumulative doses up to 12,000 mg for chloroquine and 18,000 mg for hydroxychloroquine were found. In prophylaxis clinical trials, 72,000 mg and 22,500 mg were the maximum cumulative doses for hydroxychloroquine and chloroquine respectively. Only 48% of the clinical trials considered retinal impairment as an exclusion criterion, and just one referred to an ophthalmic examination previous to study inclusion. How chloroquine and hydroxychloroquine treatment affect patients with a previous retinal condition is still poorly understood. A comprehensive ophthalmological examination 6 months after treatment is recommended in this subgroup. This review provides an overview of this topic and sheds light on the challenges visual caregivers may face regarding these repurposed drugs.

Download Full-text

Ocular Side-effects of Long-term Immunosuppressive Therapy in Recipients of Cadaver Kidney Transplants

Ophthalmic Research ◽

10.1159/000264383 ◽

1970 ◽

Vol 1 (1) ◽

pp. 21-30 ◽

Cited By ~ 18

Author(s):

R. Kern ◽

K. Záruba ◽

W. Scheitlin

Keyword(s):

Side Effects ◽

Immunosuppressive Therapy ◽

Kidney Transplants ◽

Ocular Side ◽

Cadaver Kidney

Download Full-text

Corneal side effects induced by EGFR-inhibitor antibody–drug conjugate ABT-414 in patients with recurrent glioblastoma: a prospective clinical and confocal microscopy study

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920907543 ◽

2020 ◽

Vol 12 ◽

pp. 175883592090754 ◽

Cited By ~ 2

Author(s):

Raffaele Parrozzani ◽

Giuseppe Lombardi ◽

Edoardo Midena ◽

Francesca Leonardi ◽

Davide Londei ◽

...

Keyword(s):

Side Effects ◽

Confocal Microscopy ◽

Corneal Epithelium ◽

Recurrent Glioblastoma ◽

Treatment Discontinuation ◽

Nerve Plexus ◽

Egfr Inhibitor ◽

Corneal Nerves ◽

Subbasal Nerve Plexus

Background: The aim of this study was to prospectively analyse, for the first time worldwide by in vivo clinical confocal microscopy (CCM), corneal side effects secondary to the use of epidermal growth factor receptor (EGFR) inhibitor depatuxizumab mafodotin (ABT-414) in a cohort of patients affected by EGFR-amplified recurrent glioblastoma. Methods: Each enrolled patient underwent full ophthalmologic examination including in vivo CCM of the cornea. Each patient was examined at baseline and every 2 weeks during treatment as long as patient conditions allowed it. Results: A total of 10 patients were consecutively enrolled. Median follow-up was 5 months. No Common Terminology Criteria for Adverse Events Version 4.0 grade 4 toxicity was documented. Two (20%) grade 3 toxicities were documented at week 8. CCM examination detected in all eyes multiple and diffuse hyperreflective white round spots in the corneal basal epithelial layers (100%), progressive subbasal nerve plexus layer fibres fragmentation followed by full disappearance (100%) and appearance of round cystic structures in the corneal epithelium (100%). All CCM documented side effects reached the peak of prevalence and severity after a median of 3 infusions. After treatment discontinuation, the reversibility of corneal side effects was documented at CCM after a median of 4 weeks. Conclusion: ABT-414 toxicity is not only directed to the corneal epithelium, but also to corneal nerves. Side effects are detectable in all treated patients and CCM documents early corneal epithelium and subbasal nerve plexus toxicity, with subsequent progressive restoration after treatment discontinuation. Ocular side effects due to ABT-414 can be manageable.

Download Full-text

A New Look at the Ocular Side-Effects of Long-Term Systemic Corticosteroid and Adrenocorticotrophic Therapy [Abridged]

Proceedings of the Royal Society of Medicine ◽

10.1177/003591577006300823 ◽

1970 ◽

Vol 63 (8) ◽

pp. 791-792 ◽

Cited By ~ 1

Author(s):

John Williamson

Keyword(s):

Side Effects ◽

Systemic Corticosteroid ◽

Ocular Side ◽

New Look

Download Full-text

Cutaneous ulcers following hydroxyurea therapy

Phlebologie ◽

10.1055/s-0037-1621559 ◽

2004 ◽

Vol 33 (06) ◽

pp. 202-205 ◽

Cited By ~ 2

Author(s):

K. Hartmann ◽

S. Nagel ◽

T. Erichsen ◽

E. Rabe ◽

K. H. Grips ◽

...

Keyword(s):

Side Effects ◽

Side Effect ◽

Antineoplastic Agent ◽

Limited Time ◽

Myeloproliferative Diseases ◽

Dermatological Side Effects ◽

Chronic Myeloproliferative Diseases ◽

Hydroxyurea Therapy

SummaryHydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

Download Full-text