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Drug-Induced Lupus Associated With COL-3
Report of 3 Cases
Jayashri V. Ghate, MD;
Maria L. Turner, MD;
Michelle A. Rudek, BS;
William D. Figg, PharmD;
William Dahut, MD;
Valerie Dyer, RN;
James M. Pluda, MD;
Eddie Reed, MD
Arch Dermatol. 2001;137:471-474.
Background Anti-angiogenesis is an exciting new approach to anticancer therapy. COL-3, a tetracycline derivative, is a novel anti-angiogenesis agent with potent preclinical anticancer activity. During the conduct of a phase 1 clinical trial for refractory metastatic cancer at the National Institutes of Health, we observed 3 individuals who developed phototoxicity followed by clinical and laboratory features of drug-induced lupus.
Observations Three of 35 patients treated with COL-3 developed sunburnlike eruptions accompanied by fever and a positive antinuclear antibody titer within 8 to 29 days of starting treatment. Two of 3 had positive antihistone antibody levels and arthralgia. One patient had marked systemic manifestations including pulmonary infiltrates and elevated erythrocyte sedimentation rate remittent for more than 1 year after discontinuing COL-3 treatment. The other 2 patients' symptoms and rash abated within 2 weeks of discontinuing therapy although the serologic markers remained abnormal for the duration of follow-up.
Conclusions COL-3 is the second tetracycline derivative to be implicated in the development of drug-induced lupus. A sunburnlike eruption immediately preceded or accompanied the systemic and serologic changes in these 3 patients. The rapid onset and the phototoxic appearance of the accompanying eruptions might suggest that damage to the keratinocytes caused the formation of neoantigens to which autoantibodies formed.
From the Dermatology Branch, Division of Clinical Sciences (Drs Ghate and Turner), Medicine Branch, Division of Clinical Sciences (Mss Rudek and Dyer and Drs Figg, Dahut, and Reed), and Investigational Drug Branch, Division of Cancer Treatment and Diagnosis (Dr Pluda), National Cancer Institute, Bethesda, Md.
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