Preparations of exploration of immediate hypersensitivity to antineoplastic agents: An oncology pharmacy perspective

2021 ◽  
pp. 107815522110356
Author(s):  
Amélie Dubromel ◽  
Anne-Gaëlle Caffin ◽  
Florence Hacard ◽  
Nicolas Vantard ◽  
Amandine Baudouin ◽  
...  
Keyword(s):  
Antineoplastic Agents ◽  
Manufacturing Cost ◽  
Hourly Wage ◽  
Antineoplastic Drugs ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Material Resources ◽  
Culprit Drug ◽  
Improving Patient Care ◽  
To Receive

Background Cancer patients are being exposed to antineoplastic drugs more frequently and for longer periods, resulting in a higher risk of hypersensitivity reactions. The aim of this study was to assess the pharmaceutical time and direct cost of drug allergy explorations following immediate hypersensitivity reactions to antineoplastic agents. Methods A micro-costing method was used to collect data on consumption of human and material resources for allergy exploration preparations. The monetisation was carried out on the basis of prices and hourly wage costs applied in 2018. The number and type of allergy explorations prepared by the pharmacy as well as nature of antineoplastic drugs tested, and the number of culprit drugs reintroductions were collected. Results Almost 1.5 h is required to realise allergy tests for one patient including pharmacist time for prescription analysis and pharmacy technician's time for tests preparation. The mean manufacturing cost of these tests is estimated at €62.87 (€57.82–65.49) per culprit drug for one patient. Programming patients according to culprit drugs tested allows rationalising healthcare provider time and increasing efficiency. From January 2010 to December 2018, 277 patients were tested and 490 allergy explorations were performed, corresponding to more than 5000 preparations. Mostly, the culprit drug could be reintroduced ( n = 383, 78.2%) allowing patients to receive the best possible treatment. Conclusion Management of hypersensitivity reactions is constantly progressing, as it contributes to improving patient care in oncology. This activity is time-consuming for the pharmacy team but allows patients with previous hypersensitivity reaction to continue effective treatment.

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

2021 ◽  
Vol 19 (1) ◽  
pp. 46-49
Author(s):  
Ferda Bilgir ◽  
Gökhan Kabadayı ◽  
Servet Akar
Keyword(s):  
T Cell Activation ◽  
Cell Activation ◽  
Biological Agents ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Insufficient Response ◽  
Desensitization Protocol ◽  
To Receive

ABSTRACT 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

Evaluation of Hypersensitivity Reactions in Pediatric Patients Using Biological Drugs

2021 ◽  
pp. 1-8
Author(s):  
Ozge Yilmaz Topal ◽  
Volkan Kose ◽  
Banu Acar ◽  
Umut Selda Bayrakci ◽  
Derya Ozyoruk ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Additional Treatment ◽  
Hypersensitivity Reactions ◽  
Biological Drugs ◽  
Rheumatologic Diseases ◽  
Culprit Drug ◽  
Dose Infusion ◽  
History Of ◽  
Oncologic Diseases ◽  
Biologic Drug

<b><i>Introduction:</i></b> Biological drugs are currently used for the treatment of chronic inflammatory, autoimmune, and neoplastic diseases. With their expanding indication spectrum and increasing use, hypersensitivity reactions to these drugs are also becoming more frequent. The present study aimed to report the incidence and the features of such reactions in pediatric patients using biologicals for the treatment of various diseases. <b><i>Methods:</i></b> The medical records of pediatric patients treated with biological agents between October 1, 2011 and August 31, 2019 were reviewed and adverse reactions were evaluated retrospectively. <b><i>Results:</i></b> During the study period, 211 patients (116 boys, 55%) used 21 different biological drugs for the treatment of various diseases. Their median age at the time of the first treatment was 139.9 (IQR: 92.2–187.8) months. Hematologic-oncologic diseases were the most common indication for biological therapy (97/211; 46.0%), followed by rheumatologic diseases (82/211; 38.9%). Of the 211 patients, 14 (6.64%) experienced reactions to biological drugs. The most common culprit agent was rituximab (57.1%). Most of the patients (85.7%) had a history of reactions either during the infusion or within 1 h after taking the drug. Five patients underwent desensitization to the culprit drug, while 7 other patients continued treatment with a reduced dose/infusion rate or premedication. Also 1 patient continued to take the drug without any additional treatment. <b><i>Conclusion:</i></b> It was reported that 6.64% of the patients who received biologic drug therapy for various reasons in our hospital had hypersensitivity. The most common culprit agent was rituximab, and most of the reactions were immediate reactions.

Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy

2021 ◽  
pp. 107815522110039
Author(s):  
Christine Barrett ◽  
Seon Jo Park ◽  
Lindsay Edmondson ◽  
Dulabh Monga
Keyword(s):  
Observational Study ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Controlled Trials ◽  
Severe Reaction ◽  
Hypersensitivity Reactions ◽  
H1 Receptor ◽  
Receptor Antagonists ◽  
Randomized Controlled ◽  
To Receive

Objective This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. Methods This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. Results Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. Conclusion In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.

scholarly journals Prospective study of 5-day challenge with penicillins in children

2020 ◽  
Vol 4 (1) ◽  
pp. e000734
Author(s):  
Birgitte Tusgaard Petersen ◽  
Josefine Gradman
Keyword(s):  
Prospective Study ◽  
Children And Adolescents ◽  
Provocation Test ◽  
Specific Ige ◽  
Hypersensitivity Reactions ◽  
Skin Reactions ◽  
Full Dose ◽  
Culprit Drug ◽  
Drug Provocation Test ◽  
Registration Number

ObjectivesTo examine if a 5-day challenge with penicillin improves the diagnostic sensitivity compared with a single full dose in children with mild skin reactions.DesignSubjects referred with suspected allergy to penicillin were consecutively included. Irrespectively of the morphology of the index reaction and the result of specific IgE, all subjects underwent a two-step titrated drug provocation test (DPT) with the culprit drug followed by a 5-day challenge at home.ParticipantsChildren and adolescents aged 0–18 years referred to allergic workup for penicillin hypersensitivity at two paediatric Danish centres. Only subjects with non-severe skin reactions were included.ResultsA total of 305 subjects were included and 22 (7%) of the DPTs were positive. Three subjects reacted within 1 hour of the first full dose and nine reacted 1–8 hours after the first full dose. Additional 10 positive reactions were observed during the prolonged provocation. Seven subjects reacted after the second full dose and three reacted after 3–6 days. Only mild skin rashes were observed. Eighteen subjects had a specific IgE to a penicillin >0.1 kU/L. Only one of these had a positive DPT.ConclusionIn children, a DPT with penicillins should include at least two full doses. In children with mild hypersensitivity reactions it may be safe to perform DPTs despite a low specific IgE.Trial registration numberNCT04331522

Delayed and immediate hypersensitivity reactions associated with the use of amalgam

BDJ ◽  
2000 ◽  
Vol 188 (2) ◽  
pp. 73-76 ◽  
Author(s):  
B McGivern ◽  
M Pemberton ◽  
E D Theaker ◽  
J A G Buchanan ◽  
M H Thornhill
Keyword(s):  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity

scholarly journals Hypersensitivity reactions to antineoplastic agents in BRCA-mutated ovarian cancer (OC) patients: a single centre experience

2016 ◽  
Vol 27 ◽  
pp. vi298
Author(s):  
E. Maccaroni ◽  
R. Bracci ◽  
R. Giampieri ◽  
F. Bianchi ◽  
L. Belvederesi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Antineoplastic Agents ◽  
Hypersensitivity Reactions ◽  
Single Centre ◽  
Single Centre Experience

Immediate hypersensitivity reactions of the heart: Reduction of tachycardia and arrhythmias by the SRS-A antagonist FPL 55712

1980 ◽  
Vol 2 (2) ◽  
pp. 173-176 ◽  
Author(s):  
Roberto Levi ◽  
James A. Burke ◽  
Betsy A. Holland ◽  
Frank J. Green
Keyword(s):  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity

scholarly journals Safety Assessment of Hydrolyzed Wheat Protein and Hydrolyzed Wheat Gluten as Used in Cosmetics

2018 ◽  
Vol 37 (1_suppl) ◽  
pp. 55S-66S ◽  
Author(s):  
Christina Burnett ◽  
Wilma F. Bergfeld ◽  
Donald V. Belsito ◽  
Ronald A. Hill ◽  
Curtis D. Klaassen ◽  
...  
Keyword(s):  
Safety Assessment ◽  
Expert Panel ◽  
Average Molecular Weight ◽  
Wheat Gluten ◽  
Safety Data ◽  
Hypersensitivity Reactions ◽  
Wheat Protein ◽  
Laboratory Studies ◽  
Immediate Hypersensitivity

The Cosmetic Ingredient Review (CIR) Expert Panel (Panel) reviewed the product use, formulation, and safety data on hydrolyzed wheat protein and hydrolyzed wheat gluten, which function as skin- and hair-conditioning agents. The Panel determined that data from clinical and laboratory studies were sufficient to demonstrate that these ingredients will not elicit type 1 immediate hypersensitivity reactions in sensitized individuals and will not induce sensitization when the polypeptide lengths of the hydrolysates do not exceed 30 amino acids. The Panel concluded that hydrolyzed wheat gluten and hydrolyzed wheat protein are safe for use in cosmetics when formulated to restrict peptides to an average molecular weight of 3,500 Da or less.

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