Effective Desensitization to Tocilizumab in Delayed Hypersensitivity Reaction

Cortellini, Gabriele; Mascella, Fabio; Simoncelli, Margherita; Lippolis, D; Focherini, M. C.; Cortellini, Fabio; Cherubini, Chiara; Gavioli, Barbara; Ballardini, G.

doi:10.1159/000490419

Cited by 13 publications

(14 citation statements)

References 9 publications

(8 reference statements)

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“…Regarding NIHRs, cases of nonimmediate urticaria, 141 DRESS, 142,143 SJS, 144 and AGEP 145 were reported. Younger age, shorter stature, lighter weight, and increased disease activity in the early period of tocilizumab administration have been identified as risk factors for DHRs 146 …”

Section: Anti‐cytokine/anti‐inflammatory Drugs Used For Mas/cytokine mentioning

confidence: 99%

“…Only one study revealed that STs have a low negative predictive value in NIHR 140 . Desensitization to tocilizumab in NIHRs was effectively applied in a weekly scheme with premedication in one case 141 . Rapid drug desensitization is successfully and routinely used for IHRs 19,134 (Table 3).…”

Section: Anti‐cytokine/anti‐inflammatory Drugs Used For Mas/cytokine mentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19: An EAACI Position Paper

Gelincik

Brockow

Çelik

et al. 2020

Allergy

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Coronavirus disease 2019 (COVID‐19), a respiratory tract infection caused by a novel human coronavirus, the severe acute respiratory syndrome coronavirus 2, leads to a wide spectrum of clinical manifestations ranging from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Given the huge influence caused by the overwhelming COVID‐19 pandemic affecting over three million people worldwide, a wide spectrum of drugs is considered for the treatment in the concept of repurposing and off‐label use. There is no knowledge about the diagnosis and clinical management of the drug hypersensitivity reactions that can potentially occur during the disease. This review brings together all the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off‐label drugs and highlights relevant recommendations. Furthermore, it gathers all the dermatologic manifestations reported during the disease for guiding the clinicians to establish a better differential diagnosis of drug hypersensitivity reactions in the course of the disease.

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Section: Anti‐cytokine/anti‐inflammatory Drugs Used For Mas/cytokine mentioning

confidence: 99%

Section: Anti‐cytokine/anti‐inflammatory Drugs Used For Mas/cytokine mentioning

confidence: 99%

Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19: An EAACI Position Paper

Gelincik

Brockow

Çelik

et al. 2020

Allergy

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“…A recent publication proved that desensitization is a safe and cost-effective procedure [3]. Desensitization to drugs used in rheumatology such as TNF blockers , rituximab [8,15,18,19,[30][31][32][33][34][35][36][37][38][39][40][41][42], tocilizumab [43][44][45][46][47][48], IL-17 blockers (ixekizumab) [49] and anti-IL-1 (anakinra) [50][51][52][53] has been described. Most of the described procedures were performed in patients with rheumatoid arthritis [8,32] but desensitization in patients with lupus or spondyloarthropathies [24], adult-onset Still disease [43], IgG4-related disease [40] and autoinflammatory disorders [51][52][53] has also been performed with success.…”

Section: Medical Indicationsmentioning

confidence: 99%

“…Most of the described procedures were performed in patients with rheumatoid arthritis [8,32] but desensitization in patients with lupus or spondyloarthropathies [24], adult-onset Still disease [43], IgG4-related disease [40] and autoinflammatory disorders [51][52][53] has also been performed with success. In most of the published cases desensitization was performed in patients with immediate reactions, but single reports on successful desensitization in delayed reactions [47] and serum sickness disease (type III reaction) [34] have been published as well. Table I presents the published cases of desensitization to biological agents used in rheumatic diseases.…”

Section: Medical Indicationsmentioning

confidence: 99%

Desensitization to biological agents used in rheumatology

Makowska

Lewandowska–Polak

2020

Reumatologia

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Biological agents such as monoclonal antibodies and fusion proteins are widely used for the treatment of patients with various rheumatic disorders, influencing the quality of life, disability and even mortality in patients. However, biological agents can evoke adverse reactions of different grades of severity. Although drug avoidance remains a gold standard in the care of patients hypersensitive to medication, in certain clinical situations the culprit drug is the drug of choice and cannot be replaced by another equally effective compound. In such cases, desensitization can allow the patient to be treated within current guidelines and with the most effective treatment. The authors searched Medline and Scopus databases for English-language sources using the following key words: hypersensitivity, desensitization, biologicals, adalimumab, etanercept, adalimumab, certolizumab, golimumab, rituximab, infliximab, ixekizumab, tocilizumab, anakinra and canakinumab. The aim of our review is to present the current knowledge about desensitization to biological agents and some guidelines according to patient inclusion, contraindications, procedures, and safety requirements. Drug desensitization is a new issue in rheumatology, and the solution to the problem of allergic reactions to biological drugs, which gives patients with rheumatic diseases the opportunity to extend and prolong their therapy. The present article is one of the first widely discussing this topic in the biological treatment of rheumatic diseases.

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“…Allergological study: Cutaneous testing with tocilizumab is usually performed at 20 mg/ml for the prick-test and 0.2 mg/ml [29], 20 mg/ml [52] or 2 mg/ml [49,53] for the intradermal test. If skin tests are negative, a DPT can be performed after evaluating the risk-benefit ratio and switching to a subcutaneous route can be considered [49].…”

Section: Rationale: Studies Conducted In Patients Who Died Of Sars Anmentioning

confidence: 99%