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Intern Med. 2019 Jan 1;58(1):67-71. doi: 10.2169/internalmedicine.0843-18. Epub 2018 Aug 24.

Accelerated Progression of Hepatocellular Carcinoma during Immunosuppressive Therapy with Abatacept for Rheumatoid Arthritis.

Author information

1
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Japan.
2
Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Japan.

Abstract

Abatacept, a cytotoxic T lymphocyte antigen-4 immunoglobulin recombinant fusion protein, is an immunosuppressive agent indicated for rheumatoid arthritis. Although no significant increase in malignancy has been reported in abatacept-treated patients, whether or not abatacept accelerates tumor progression in specific cancer types remains unclear. We herein report a 66-year-old woman who showed unusually rapid progression of hepatocellular carcinoma following abatacept therapy for rheumatoid arthritis. Abatacept was speculated to have accelerated her hepatocellular carcinoma progression in the setting of her preexisting risk factors: autoimmune hepatitis and long-term methotrexate use. We propose close tumor surveillance be performed during abatacept therapy, especially for high-risk patients.

KEYWORDS:

abatacept; cancer immunity; cytotoxic T lymphocyte antigen-4 (CTLA-4); hepatocellular carcinoma; immunosuppressive therapy

PMID:
30146566
PMCID:
PMC6367098
DOI:
10.2169/internalmedicine.0843-18
[Indexed for MEDLINE]
Free PMC Article

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