Do you recommend the use of dexamethasone and anakinra as upfront treatment in a pediatric patient with secondary HLH (nonrheumatic) who is too ill to tolerate etoposide?
This type of etoposide sparing therapy has been previously described in a case series at https://pubmed.ncbi.nlm.nih.gov/32725881/
Answer from: at Academic Institution
If there is no concern for new malignancy or systemic infection, then glucocorticoids are reasonable. I use methylprednisolone up to 30 mg/kg/day (max. one gram). Anakinra is a safe and often effective therapy for secondary HLH. It is quick acting and has a short half-life so I use it early. I gener...
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Answer from: at Community Practice
Using Anakinra with dexamethasone is a reasonable approach for a patient with secondary HLH who cannot tolerate etoposide. This treatment regimen is well-documented in the literature. There is a definite trend toward treatment regimens that do not incorporate etoposide, such as emapalumab (currently...
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at University of Minnesota Physicians
Isn’t Epalumumab only FDA-approved for prima...
Isn’t Epalumumab only FDA-approved for prima...
at University of Alabama Birmingham
Emapalumab is being studied for secondary forms of...
Emapalumab is being studied for secondary forms of...