From the Guidelines
Skyrizi (risankizumab) is generally contraindicated in patients receiving CHOEP chemotherapy for T-cell lymphoma due to significant immunosuppressive effects and increased infection risk. This combination should be avoided as it could substantially increase the risk of serious infections, including opportunistic pathogens, as both treatments suppress immune pathways 1. Skyrizi is an IL-23 inhibitor primarily used for psoriasis and psoriatic arthritis, and its use in patients with active malignancies undergoing chemotherapy has not been established.
When considering the treatment of T-cell lymphoma, chemotherapy regimens such as CHOP are commonly used, but more intensive regimens like CHOEP may be considered in certain cases 1. However, the addition of Skyrizi to these regimens could theoretically interfere with cancer treatment efficacy, as immune function plays a role in tumor surveillance.
Key considerations for managing patients with T-cell lymphoma include:
- Prioritizing T-cell lymphoma treatment over Skyrizi therapy
- Postponing Skyrizi therapy until after completion of chemotherapy and recovery of immune function
- Coordinating care with oncology and dermatology consultations to ensure optimal management of both conditions
- Avoiding the use of Skyrizi in patients with active malignancies undergoing chemotherapy due to the lack of established safety and potential increased risk of infections and impaired cancer treatment efficacy 1.
From the Research
Skyrizi Use in Patients Receiving CHOP Chemotherapy for T Cell Lymphoma
- There are no direct studies on the use of Skyrizi in patients receiving CHOP chemotherapy for T cell lymphoma.
- However, studies have investigated the use of CHOP chemotherapy in patients with T cell lymphoma, including peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL) 2, 3.
- The CHOP regimen has been compared to other chemotherapy regimens, such as GEM-P and THP-COP, in patients with T cell lymphoma 2, 3.
- The use of alemtuzumab (Campath-1H) in combination with CHOP chemotherapy has been investigated as a first-line treatment for patients with peripheral T-cell lymphoma, with promising results 4.
- However, the safety and efficacy of Skyrizi in combination with CHOP chemotherapy for T cell lymphoma are unknown, and further studies are needed to determine its potential use in this setting.
- It is essential to consult the prescribing information for Skyrizi and CHOP chemotherapy to understand their approved uses, dosing, and potential interactions.
- The studies provided do not directly address the use of Skyrizi with CHOP chemotherapy for T cell lymphoma, and therefore, no specific contraindications can be determined from the available evidence 2, 3, 5, 4, 6.