Drug General Information (ID: DDIUMICT30)
Drug Name			Prednisolone		Drug Info		Ipilimumab		Drug Info
Drug Type		Small molecule				Monoclonal antibody
Therapeutic Class		Antineoplastics				Antineoplastics

Mechanism of Prednisolone-Ipilimumab Interaction (Severity Level: Moderate)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Prednisolone				Ipilimumab
Mechanism		Immunosuppressive effects				Immunosuppressive effects
Key Mechanism Factor 1
		Factor Name		Immunosuppressive effects
		Factor Description		Immunosuppression is when your immune system is not functioning as it should. The immune system is made up of cells, tissues and organs that help the body fight off infections. If the immune system is suppressed, an infection that your body was able to control may become serious or even fatal.
Mechanism Description		Additive immunosuppressive effects by the combination of Prednisolone and Ipilimumab

Recommended Action
Management		The manufacturers' product labeling should be consulted for specific recommendations. If clinically possible, the use of systemic corticosteroids should be avoided at the time of or within 30 days of starting therapy with an ICI, e.g., durvalumab, nivolumab, pembrolizumab, ipilimumab, cemiplimab, or atezolizumab. Corticosteroids may be used for the treatment of immune-mediated reactions after starting an ICI. Some manufacturers advise that corticosteroids may be used as premedication, when the ICI is used in combination with chemotherapy, as antiemetic prophylaxis, and/or to alleviate chemotherapy-related adverse effects.

References
1	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
2	Arbour KC, Mezquita L, Long N, et al. "Impact of Baseline Steroids on Efficacy of Programmed Cell Death-1 and Programmed Death-Ligand 1 Blockade in Patients With Non-Small-Cell Lung Cancer." J Clin Oncol 36 (2018): 2872-2878. [PMID: 30125216]
3	Cerner Multum, Inc "ANVISA Bulario Eletrnico.".
4	Cerner Multum, Inc. "Australian Product Information.".
5	Cerner Multum, Inc. "Canadian Product Information.".
6	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
7	Jove M, Vilarino N, Nadal E "Impact of baseline steroids on efficacy of programmed cell death-1 (PD-1) and programmed death-ligand 1 (PD-L1) blockade in patients with advanced non-small cell lung cancer." Transl Lung Cancer Res 8 (2019): S364-8. [PMID: 32038916]
8	Scott SC, Pennell NA "Early use of systemic corticosteroids in patients with advanced NSCLC treated with nivolumab." J Thorac Oncol 13 (2018): 1771-5. [PMID: 29935305]
9	Fuca G, Galli G, Poggi M, et.al "Modulation of peripheral blood immune cells by early use of steroids and its association with clinical outcomes in patients with metastatic non-small cell lung cancer treated with immune checkpoint inhibitors." ESMO Open 4 (2019): e000457. [PMID: 30964126]
10	Horvat TZ, Adel NG, Dand TO, et.al "Immune-related adverse events, need for systemic immunosuppression, and effects on survival and time to treatment failure in patients with melanoma treated with ipilimumab at Memorial Sloan Kettering Cancer Center." J Clin Oncol 33 (2015): 3193-8. [PMID: 26282644]