Sugammadex Hypersensitivity—A Case of Anaphylaxis

Jeyadoss, Jellsingh; Kuruppu, P; Nanjappa, Naveen; Wijk, Roelof Van

doi:10.1177/0310057x1404200115

Cited by 28 publications

(20 citation statements)

References 15 publications

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“…Four were in Japanese [14][15][16][17]; three were not primary investigations [18][19][20]; in the six from the MHRA, sufficient detail of the hypersensitivity reaction could not be disclosed owing to concerns over patient confidentiality; and one included a probable alternative explanation for the reaction [21]. We identified a total of 11 studies to be included in the qualitative analysis, including: two case series of three patients each [22,23]; six case reports [24][25][26][27][28][29]; an abstract [30]; and two clinical trials [7,31]. Table 1 summarises all the included patients.…”

Section: Methodsmentioning

confidence: 99%

Hypersensitivity associated with sugammadex administration: a systematic review

2014

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SummarySugammadex is a drug used to reverse neuromuscular blockade induced by rocuronium or vecuronium. It has not yet been approved by the Food and Drug Administration in the USA due to concerns regarding hypersensitivity. The objective of this review was to identify similarities in the presentation of hypersensitivity reactions to sugammadex. A comprehensive search was performed in PubMed, Scopus and Web of Science for cases reporting hypersensitivity reactions to sugammadex. In addition, we contacted regulatory agencies and the company marketing the drug for unpublished reports. Reports were included if they were in English, primary investigations, lacked an alternative probable explanation for the reaction and included a comprehensive description of the hypersensitivity. We identified 15 cases of hypersensitivity following sugammadex administration.

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Section: Methodsmentioning

confidence: 99%

Hypersensitivity associated with sugammadex administration: a systematic review

2014

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“…Most frequently reported side effects of SUG administration are pain, nausea, coughing, headache or vomiting 2,10, being the hypersensitivity reactions, ranging from erythema to anaphylactic shock, are the most alarming among them 27,28,29. Furthermore, allergy to NMB has been considered the first cause of perioperative anaphylaxis 30,31.…”

Section: Discussionmentioning

confidence: 99%

Neuronal Effects of Sugammadex in combination with Rocuronium or Vecuronium

Aldasoro¹,

Vallés²,

Aldasoro

et al. 2017

Int. J. Med. Sci.

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Rocuronium (ROC) and Vecuronium (VEC) are the most currently used steroidal non-depolarizing neuromuscular blocking (MNB) agents. Sugammadex (SUG) rapidly reverses steroidal NMB agents after anaesthesia. The present study was conducted in order to evaluate neuronal effects of SUG alone and in combination with both ROC and VEC. Using MTT, CASP-3 activity and Western-blot we determined the toxicity of SUG, ROC or VEC in neurons in primary culture. SUG induces apoptosis/necrosis in neurons in primary culture and increases cytochrome C (CytC), apoptosis-inducing factor (AIF), Smac/Diablo and Caspase 3 (CASP-3) protein expression. Our results also demonstrated that both ROC and VEC prevent these SUG effects. The protective role of both ROC and VEC could be explained by the fact that SUG encapsulates NMB drugs. In BBB impaired conditions it would be desirable to control SUG doses to prevent the excess of free SUG in plasma that may induce neuronal damage. A balance between SUG, ROC or VEC would be necessary to prevent the risk of cell damage.

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“…Some reports described sugammadex‐induced anaphylactic reactions in adults . A previous study reported that incidence proportion of sugammadex‐induced anaphylactic reactions was estimated to be 0.003% .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Some reports described sugammadex-induced anaphylactic reactions in adults. [4][5][6][7][8][9][10] A previous study reported that incidence Accepted: 24 April 2018 DOI: 10.1111/pan.13401 proportion of sugammadex-induced anaphylactic reactions was estimated to be 0.003%. 7 However, the data were obtained from anesthesiologists on a voluntary basis, and may have been underreported.…”

Section: Introductionmentioning

confidence: 99%