Interferon-β-1a

Reactions 1423 - 13 Oct 2012 S Interferon-β-1a Lobular panniculitis and lipoatrophy: case report A 42-year-old woman developed painful lobular panniculitis and lipoatrophy of her thighs while receiving self-administered IM interferon-β-1a; it was subsequently established that her injection technique was incorrect. The woman had been receiving IM interferon-β-1a 30µg [Avonex] for stable relapsing-remitting multiple sclerosis. She administered the drug to herself weekly, alternating injections to the front sides of her thighs. After 3 years of IM treatment with the drug, she presented with lipoatrophy and painful red indurations affecting both lateral thighs. She reported that she had started to experience lipoatrophy adjacent to the IM injections sites after approximately 2 years of treatment; her symptoms were progressively worsening, and had been accompanied by severe local pain and skin reddening in the months preceding presentation. MRI of her thighs showed marked oedema and atrophy of her subcutis, and deep skin biopsy indicated lymphocytic lobular panniculitis with local fat necrosis. Evaluation of the woman’s injection technique indicated that she was using the wrong injection angle; she received further injection training and continued to received IM interferon-β-1a. Her pain and skin erythema resolved in a few weeks, but she experienced irreversible disfiguring lipoatrophy. Author comment: "Our report highlights that patients, who are switched from SC to IM [interferon-β-1a] due to severe inflammatory skin reactions, should received sustained skin observance, as severe skin adverse effects may rarely also occur with [IM interferon-β-1a] due to an incorrect injection technique." Weise G, et al. Lobular panniculitis and lipoatrophy of the thighs with interferon- beta-1a for intramuscular injection in a patient with multiple sclerosis. Journal of Clinical Neuroscience 19: 1312-1313, No. 9, Sep 2012. Available from: URL: http://dx.doi.org/10.1016/j.jocn.2011.11.026 - Germany 803078351 1 Reactions 13 Oct 2012 No. 1423 0114-9954/10/1423-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Transcript of Interferon-β-1a

Reactions 1423 - 13 Oct 2012

SInterferon-β-1a

Lobular panniculitis and lipoatrophy: case reportA 42-year-old woman developed painful lobular

panniculitis and lipoatrophy of her thighs while receivingself-administered IM interferon-β-1a; it was subsequentlyestablished that her injection technique was incorrect.

The woman had been receiving IM interferon-β-1a 30µg[Avonex] for stable relapsing-remitting multiple sclerosis.She administered the drug to herself weekly, alternatinginjections to the front sides of her thighs. After 3 years of IMtreatment with the drug, she presented with lipoatrophyand painful red indurations affecting both lateral thighs. Shereported that she had started to experience lipoatrophyadjacent to the IM injections sites after approximately2 years of treatment; her symptoms were progressivelyworsening, and had been accompanied by severe local painand skin reddening in the months preceding presentation.MRI of her thighs showed marked oedema and atrophy ofher subcutis, and deep skin biopsy indicated lymphocyticlobular panniculitis with local fat necrosis.

Evaluation of the woman’s injection technique indicatedthat she was using the wrong injection angle; she receivedfurther injection training and continued to received IMinterferon-β-1a. Her pain and skin erythema resolved in afew weeks, but she experienced irreversible disfiguringlipoatrophy.

Author comment: "Our report highlights that patients,who are switched from SC to IM [interferon-β-1a] due tosevere inflammatory skin reactions, should received sustainedskin observance, as severe skin adverse effects may rarely alsooccur with [IM interferon-β-1a] due to an incorrect injectiontechnique."Weise G, et al. Lobular panniculitis and lipoatrophy of the thighs with interferon-beta-1a for intramuscular injection in a patient with multiple sclerosis. Journal ofClinical Neuroscience 19: 1312-1313, No. 9, Sep 2012. Available from: URL:http://dx.doi.org/10.1016/j.jocn.2011.11.026 - Germany 803078351