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Pembrolizumab/rivaroxaban interaction

Pembrolizumab/rivaroxaban interaction Reactions 1704, p304 - 2 Jun 2018 X S Intracerebellar haemorrhage: case report A 78-year-old man developed intracerebellar haemorrhage following concomitant use of pembrolizumab and rivaroxaban [durations of treatments to reactions onsets not stated]. The man had a history significant for rheumatoid arthritis, atrial fibrillation, coronary artery disease, hypertension, diabetes mellitus, and hypothyroidism. His ongoing medications included rivaroxaban for atrial fibrillation [dosage and route not stated] and prednisone for rheumatoid arthritis. In 2009, he presented with a forehead melanoma and underwent surgeries over a period of three years. In August 2016, the forehead melanoma re-appeared along with bilateral periparotid lymphadenopathy, hence he started receiving immunotherapy with IV pembrolizumab 2 mg/kg every three weeks. He received six doses of pembrolizumab over a period of 4 months. However, during the therapy he developed spontaneous intracerebellar haemorrhage. The man’s pembrolizumab therapy was discontinued in December 2016. Subsequently, his haemorrhage resolved without any further complications. The development of intracerebellar haemorrhage was considered to be due to excessive anticoagulation due to their impaired metabolism from pembrolizumab therapy. Author comment: "Factor Xa inhibitors are metabolized by the hepatic CYP3/A4 system; thus, any effects of PD-1 inhibitors on this enzyme might have implications for the metabolism http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Pembrolizumab/rivaroxaban interaction

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018

Pembrolizumab/rivaroxaban interaction

Abstract

Reactions 1704, p304 - 2 Jun 2018 X S Intracerebellar haemorrhage: case report A 78-year-old man developed intracerebellar haemorrhage following concomitant use of pembrolizumab and rivaroxaban [durations of treatments to reactions onsets not stated]. The man had a history significant for rheumatoid arthritis, atrial fibrillation, coronary artery disease, hypertension, diabetes mellitus, and hypothyroidism. His ongoing medications included rivaroxaban for atrial fibrillation [dosage and route...
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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
DOI
10.1007/s40278-018-46947-2
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p304 - 2 Jun 2018 X S Intracerebellar haemorrhage: case report A 78-year-old man developed intracerebellar haemorrhage following concomitant use of pembrolizumab and rivaroxaban [durations of treatments to reactions onsets not stated]. The man had a history significant for rheumatoid arthritis, atrial fibrillation, coronary artery disease, hypertension, diabetes mellitus, and hypothyroidism. His ongoing medications included rivaroxaban for atrial fibrillation [dosage and route not stated] and prednisone for rheumatoid arthritis. In 2009, he presented with a forehead melanoma and underwent surgeries over a period of three years. In August 2016, the forehead melanoma re-appeared along with bilateral periparotid lymphadenopathy, hence he started receiving immunotherapy with IV pembrolizumab 2 mg/kg every three weeks. He received six doses of pembrolizumab over a period of 4 months. However, during the therapy he developed spontaneous intracerebellar haemorrhage. The man’s pembrolizumab therapy was discontinued in December 2016. Subsequently, his haemorrhage resolved without any further complications. The development of intracerebellar haemorrhage was considered to be due to excessive anticoagulation due to their impaired metabolism from pembrolizumab therapy. Author comment: "Factor Xa inhibitors are metabolized by the hepatic CYP3/A4 system; thus, any effects of PD-1 inhibitors on this enzyme might have implications for the metabolism

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References