Corticosteroid-sparing agents used in HCT-OP and non–HCT-OP with related conditions
| Agent class . | Medications used in HCT-OP∗ . | Other medications used in non–HCT-OP . | Non–HCT-OP conditions . |
|---|---|---|---|
| Antibiotic | Erythromycin16 Macrolide15 | Erythromycin59, Clarithromycin60 Azithromycin61 | COP |
| Antiproliferative | MMF62 | Azathioprine63 MMF63 Cyclophosphamide63,64 Methotrexate65 | COP, IgG4-related disease, CTD |
| Bruton tyrosine kinase inhibitor | Ibrutinib†,66 | ||
| Calcineurin inhibitor | Cyclosporine20,62,67 | Cyclosporine63 Tacrolimus68 | COP, CTD |
| Cytokine-directed therapy‡ | Etanercept§,58 Tocilizumab69,70 | Etanercept71 Infliximab72 Rituximab73,74, Tocilizumab75 IVIG76 | RA, immune check point inhibitor, COP, Sjogren disease |
| JAK1/2 inhibitor | Ruxolitinib†,46,66 | ||
| Other | ECP46,77 LABA/inhaled corticosteroid15 | Inhaled corticosteroid78 | Hodgkin lymphoma |
| Agent class . | Medications used in HCT-OP∗ . | Other medications used in non–HCT-OP . | Non–HCT-OP conditions . |
|---|---|---|---|
| Antibiotic | Erythromycin16 Macrolide15 | Erythromycin59, Clarithromycin60 Azithromycin61 | COP |
| Antiproliferative | MMF62 | Azathioprine63 MMF63 Cyclophosphamide63,64 Methotrexate65 | COP, IgG4-related disease, CTD |
| Bruton tyrosine kinase inhibitor | Ibrutinib†,66 | ||
| Calcineurin inhibitor | Cyclosporine20,62,67 | Cyclosporine63 Tacrolimus68 | COP, CTD |
| Cytokine-directed therapy‡ | Etanercept§,58 Tocilizumab69,70 | Etanercept71 Infliximab72 Rituximab73,74, Tocilizumab75 IVIG76 | RA, immune check point inhibitor, COP, Sjogren disease |
| JAK1/2 inhibitor | Ruxolitinib†,46,66 | ||
| Other | ECP46,77 LABA/inhaled corticosteroid15 | Inhaled corticosteroid78 | Hodgkin lymphoma |
CTD, connective tissue disease; ECP, extracorporeal photopheresis; IgG4, immunoglobulin G4; IVIG, intravenous immunoglobulin; JAK, Janus kinase; LABA, long-acting β agonist; MMF, mycophenolate mofetil; RA, rheumatoid arthritis.
These agents (except etanercept) were historically used, as documented in case reports and limited case series.
Agents approved by the US Food and Drug Administration for corticosteroid-refractory GVHD.
Consider checking serum cytokine level (sTNFRI [soluble tumor necrosis factor receptor type I], sTNFRII, interleukin 6 [IL-6], IL-8, and transforming growth factor-β).
Agent studied in a prospective clinical trial.