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Patients with severe telaprevir-related skin eruption can continue treatment
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Patients with grade 3 widespread morbilliform eruption associated with telaprevir can continue their triple therapy as long as they are closely monitored, according to researchers from Massachusetts General Hospital.
“With proper monitoring, it appears that patients with a grade 2 (moderate) telaprevir eruption or uncomplicated grade 3 (severe) telaprevir eruption can safely be treated symptomatically without the need for discontinuation of triple therapy,” the researchers wrote in JAMA Dermatology. “Given that triple therapy is often the last therapeutic option for patients with [hepatitis C virus], further research to examine this novel approach should be conducted prospectively.”
Eight patients with a grade 3 morbilliform eruption related to telaprevir (Incivek, Vertex) were evaluated by dermatologists a mean of 13.3 days after symptom onset. All of the patients had an eruption that covered more than half of their total body surface area, which developed a mean of 20.1 days after initiating treatment. The trunk and extremities were affected in all patients, and none had eosinophilia or liver function test results indicating systemic involvement.
The researchers reported that the morbilliform eruption lasted a mean of 54.9 days. Four patients remained affected until they completed telaprevir treatment, and no patients had to discontinue therapy due to the eruption. The patients were treated with topical corticosteroids, thick emollients and antihistamines. No patients progressed to a systemic adverse effect.
“Despite the lack of understanding the pathogenesis of telaprevir eruptions, this series demonstrates that the signs and symptoms can be managed similarly to other cutaneous drug eruptions,” the researchers wrote. “Patients can be ‘treated through’ the duration of triple therapy with an aggressive and comprehensive treatment regimen, including mid- to high-potency topical corticosteroids, thick emollient creams and antihistamines.”
Disclosure: One researcher has financial relationships with Vertex and Gilead.
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