Drug Interactions between afamitresgene autoleucel and moxifloxacin / triamcinolone

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.

GENERALLY AVOID: The use of systemic corticosteroids may reduce the efficacy of afamitresgene autoleucel, an autologous T-cell immunotherapy agent. The exact mechanism by which corticosteroids exert this effect is not clearly described; however, it may involve corticosteroid-induced T lymphocyte apoptosis. The clinical trial that evaluated the efficacy of afamitresgene autoleucel excluded patients who were on systemic corticosteroids for at least 14 days prior to leukapheresis and lymphodepletion. Therefore, clinical data examining the use of systemic corticosteroids prior to or during an infusion of afamitresgene autoleucel are not available.

MANAGEMENT: The manufacturer of afamitresgene autoleucel recommends avoiding the prophylactic use of systemic corticosteroids. Consultation with institutional protocols, national guidelines, and package labeling may be helpful.