open access

https://hdl.handle.net/2115/62582

Serum granulysin levels as a predictor of serious telaprevir-induced dermatological reactions

英語

DIHS

2015-08

Wiley

Hepatology research

45(8)

837-845

Aim: Telaprevir-based therapy for chronic hepatitis C patients is effective; however, the high prevalence of dermatological reactions is an outstanding issue. The mechanism and characteristics of such adverse reactions are unclear; moreover, predictive factors remain unknown. Granulysin was recently reported to be upregulated in the blisters of patients with Stevens-Johnson syndrome (SJS). Therefore, we investigated the risk factors for severe telaprevir-induced dermatological reactions as well as the association between serum granulysin levels and the severity of such reactions. Methods: A total of 89 patients who received telaprevir-based therapy and had complete clinical information were analyzed. We analyzed the associations between dermatological reactions and clinical factors. Next, we investigated the time-dependent changes in serum granulysin levels in five and 14 patients with grade 3 and non-grade 3 dermatological reactions, respectively. Results: Of the 89 patients, 57 patients had dermatological reactions, including nine patients with grade 3. Univariate analysis revealed that grade 3 dermatological reactions were significantly associated with male sex. Moreover, serum granulysin levels were significantly associated with the severity of dermatological reactions. Three patients with grade 3 dermatological reaction had severe systemic manifestations including SJS, drug-induced hypersensitivity syndrome, and systemic lymphoid swelling and high-grade fever; all were hospitalized. Importantly, among the three patients, two patients' serum granulysin levels exceeded 8ng/mL at onset and symptoms deteriorated within 6 days. Conclusion: Male patients are at high risk for severe telaprevir-induced dermatological reactions. Moreover, serum granulysin levels are significantly associated with the severity of dermatological reactions and may be a predictive factor in patients treated with telaprevir-based therapy.

学術雑誌論文

Accepted Manuscript

This is the peer reviewed version of the following article: Suda, G., Yamamoto, Y., Nagasaka, A., Furuya, K., Kudo, M., Chuganji, Y., Tsukuda, Y., Tsunematsu, S., Sato, F., Terasita, K., Nakai, M., Horimoto, H., Sho, T., Natsuizaka, M., Ogawa, K., Ohnishi, S., Chuma, M., Fujita, Y., Abe, R., Taniguchi, M., Nakagawa, M., Asahina, Y., Sakamoto, N., (2015) Serum granulysin levels as a predictor of serious telaprevir-induced dermatological reactions. Hepatol Res, 45: 837–845., which has been published in final form at http://doi.org/10.1111/hepr.12421. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

1386-6346

AA11140867