Non-immediate drug hypersensitivity reactions secondary to intravitreal anti-vascular endothelial growth factors

Abstract

Purpose To describe a series of non-immediate drug hypersensitivity reactions after intravitreal anti-vascular endothelial growth factors (anti-VEGFs). Patients and methods Retrospective report of 6 patients with cutaneous non-immediate drug hypersensitivity reactions following intravitreal anti-VEGF injections, 4 after ranibizumab, 1 after bevacizumab and 1 after aflibercept. Results Clinical manifestations ranged from mild maculopapular rash, purpura to severe generalized erythroderma, with or without systemic involvement such as microscopic hematuria and proteinuria or fever. In two out of the six patients, reintroduction of either the same or an alternative anti-VEGF drug did induce a recurrence of the drug hypersensitivity reaction, while 4 patients showed no recurrence. Conclusion Cutaneous non-immediate drug hypersensitivity reactions secondary to intravitreal anti-VEGF may occur. Continuation of the same drug or switch to another anti-VEGF may either induce recurrence or be well supported by the patient. The decision of drug discontinuation should be guided by the severity of the disease.

Risk of immune system and skin and subcutaneous tissue related adverse events associated with oxaliplatin combined with immune checkpoint inhibitors: a pharmacovigilance study

“…In platinum-based chemotherapy regimens, a preparation of 5-fluorouracil, epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) or vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) is commonly used simultaneously, and these drugs can also cause ISA-ADEs ( Oyama et al, 2021 ; Moret et al, 2022 ). In our study, however, we first qualified the identity of the target drug, that is, explained that it had to be a PS or SS in the report, thus ensuring the role of oxaliplatin in the occurrence of each ISA-ADE while reducing the effect of other drugs on the outcome.…”

Ocular Drug Delivery into the Eyes Using Drug-Releasing Soft Contact Lens

“…Thus, anti-VEGF therapy is a promising approach for wet AMD. Currently, anti-VEGF drugs such as bevacizumab (anti-VEGF monoclonal antibody), aflibercept (soluble decoy VEGF receptor), ranibizumab (anti-VEGF monoclonal antibody Fab fragment), brolucizumab (humanized anti-VEGF monoclonal single-chain variable fragment), and faricimab (bispecific monoclonal antibody targeting VEGF and Ang-2) are clinically used for the treatment of wet AMD [36,37]. However, they are administered via vitreous injection because monoclonal antibodies characterized as high-molecular-weight compounds cannot cross the membrane via passive diffusion due to large molecular size and hydrophilicity, which may not be patient-friendly.…”