Rapid subcutaneous desensitization for treatment of hypersensitivity reactions to etanercept in two patients with positive basophil activation test

Varga-Martínez, Raquel de la; Fernández, Diego Gutiérrez; Fernández, Antonio Foncubierta; García, José Antonio Andrés; Varo, Fermín Medina

doi:10.1016/j.alit.2016.09.002

Cited by 15 publications

(6 citation statements)

References 8 publications

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“…Reusing the agent causing the reaction is strongly prohibited in these clinical scenarios There are guidelines for the general approach and desensitization protocols for drug-induced HSRs (20). Diagnostic skin tests and desensitization protocols are performed for type 1 and certain type 4 immune responses based on these guidelines (1,15,(18)(19)(20)(21)(22)(23). However, a desensitization protocol for abatacept has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Bilgir¹,

Kabadayi²,

Akar³

2021

Asthma Allergy Immunol

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Abatacept is a fusion protein that blocks T cell activation. It is used in a variety of conditions including organ transplantation, immune deficiency, and autoimmune diseases. Even though abatacept-induced adverse events are observed, hypersensitivity reactions are rare. Desensitization protocols that can be implemented in the case of hypersensitivity reactions are present in the literature for many biological agents. However, a desensitization protocol for abatacept has not yet been established. Our patient, who was started on one of the biological agents, abatacept, for rheumatoid arthritis due to insufficient response to disease- modifying antirheumatic drugs, developed immediate hypersensitivity reaction with the first dose. Since it was planned to continue the treatment, abatacept desensitization was performed. The rapid desensitization protocol performed with prior premedication was successful and the patient was able to receive subsequent doses of abatacept using the same protocol. Keywords: Abatacept, anaphylaxis, desensitization

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Section: Discussionmentioning

confidence: 99%

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Bilgir¹,

Kabadayi²,

Akar³

2021

Asthma Allergy Immunol

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“…143,148,149 There are limited case reports on using the basophil activation test (BAT) to assess reactions to biologics. [150][151][152] Other biomarkers, such as tryptase (for a type I hypersensitivity phenotype) or IL6 (for a cytokine release syndrome), are helpful for endophenotyping. 5,23,44…”

Section: Section 4: Delabeling Allergy To Biologics In Adult Patients...mentioning

confidence: 99%

Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement

Madrigal-Burgaleta

Álvarez-Cuesta

Broyles

et al. 2022

World Allergy Organization Journal

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“…BAT may be positive even when skin testing may be negative. In one case study, two patients with localized hypersensitivity reaction etanercept had negative skin tests but positive BAT and underwent successful rapid desensitization [ 34 ]. Another case study shows a patient with severe anaphylaxis to pertuzumab with negative skin prick and intradermal tests with a positive BAT for both markers who then underwent successful rapid desensitization [ 35 ].…”

Section: Advancements In Biomarkersmentioning

confidence: 99%

Utilizing Biologics in Drug Desensitization

Yang

Castells

2022

Curr Allergy Asthma Rep

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Purpose of Review The purpose of this literature review was to review the latest advancements with biologics in rapid drug desensitization. Our methodology was to highlight both desensitization to biologics themselves and the use of biologics in desensitization to both biologic and nonbiologic drugs. Recent Findings Biologics are a vast category of drugs that include monoclonal antibodies, nanobodies, modern vaccinations, and even hormones. Desensitization to biologics can be safely performed through standardized procedure. Biomarkers are used both in vitro and in vivo to help identify and classify hypersensitivity reactions. Hypersensitivity reactions to the mRNA vaccinations against SARS-CoV-2 present their own unique challenges to management. There are specific excipients in monoclonal antibodies that are thought to be responsible for many of their hypersensitivity reactions. Certain biologics can even be used to assist in desensitization to other drugs. Summary Rapid drug desensitization is a standardized procedure that may be able to help many patients who have experienced hypersensitivity reactions to biologics and would best be treated with them to continue to receive them. Biologic drugs have opened a new era in medicine for the prevention and treatment of infectious diseases, cancer, and inflammatory diseases. Hypersensitivity reactions to biologics are quite common. This literature review presents the latest advancements in our understanding of hypersensitivity reactions to biologics, how rapid drug desensitization can be used to continue therapy despite history of hypersensitivity, and how biologics themselves can be used to aid in desensitization itself.

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Rapid subcutaneous desensitization for treatment of hypersensitivity reactions to etanercept in two patients with positive basophil activation test

Cited by 15 publications

References 8 publications

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Management and Successful Desensitization in a Patient with Abatacept-Induced Anaphylaxis

Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement

Utilizing Biologics in Drug Desensitization

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