Urosepsis Risk in Neuromyelitis Optica Spectrum Disorder Patients Administered Satralizumab

Objective The interleukin-6 (IL-6) inhibitor satralizumab is an established treatment for neuromyelitis optica spectrum disorder (NMOSD). Although IL-6 inhibitors are generally well-tolerated, serious infections, including sepsis, can occur. In this study, we compared the sepsis characteristics in N...

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Bibliographic Details
Published in:Internal Medicine 2023/11/15, Vol.62(22), pp.3317-3320
Main Authors: Fujita, Rina, Aratake, Yuriko, Nakata, Kyoko, Fujii, Chihiro, Kondo, Takayuki
Format: Article
Language:English
Subjects:
Aquaporin 4
Diabetes mellitus
Disabled Persons
Humans
Interleukin 6
Internal medicine
Medical equipment
Motor Disorders
Neuromyelitis
Neuromyelitis Optica - complications
Neuromyelitis Optica - drug therapy
Neuromyelitis Optica - epidemiology
neuromyelitis optica spectrum disorder
Original
Patients
Rheumatoid arthritis
Risk factors
satralizumab
Sepsis
Sepsis - epidemiology
Urinary tract
Urinary tract infections
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Summary:Objective The interleukin-6 (IL-6) inhibitor satralizumab is an established treatment for neuromyelitis optica spectrum disorder (NMOSD). Although IL-6 inhibitors are generally well-tolerated, serious infections, including sepsis, can occur. In this study, we compared the sepsis characteristics in NMOSD patients administered satralizumab (NMOSD-satralizumab) to those in rheumatoid arthritis patients administered tocilizumab (RA-tocilizumab), another IL-6 inhibitor. Methods We examined adverse event reports from the Japanese Pharmaceuticals and Medical Devices Agency regarding NMOSD-satralizumab from August 2020 to March 2022 and RA-tocilizumab from April 2008 to November 2019 (term 1) and to March 2022 (term 2). Results We identified 6 sepsis cases in NMOSD-satralizumab, of which 5 (83%) developed from urinary tract infections (UTIs). Although data were unavailable for two patients, three cases had urologic complications in addition to recognized risk factors for serious infections, such as an older age, corticosteroid use, obesity, diabetes mellitus and motor disability. Urosepsis was relatively infrequent in RA-tocilizumab (term 1: 24.2%, term 2: 20.1%). Conclusion Safe satralizumab use requires risk factor assessment to minimize the incidence of severe infections. Management of UTIs is also recommended.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.1642-23