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

scholarly journals Successful olaparib desensitization using a novel one-day protocol

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Rongbo Zhu ◽  
Stephen Welch ◽  
Hannah Roberts
Keyword(s):  
Adverse Reactions ◽  
Chemotherapeutic Agents ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Case Presentation ◽  
Tablet Form ◽  
Desensitization Protocol ◽  
Ige Mediated ◽  
Loss Of Tolerance

Abstract Background Olaparib is a revolutionary treatment for patients with ovarian and breast cancer. Currently, there is no established 1-day drug desensitization protocol for patients with olaparib type-1 hypersensitivity reactions despite well documented IgE-mediated adverse reactions occurring with olaparib. Case presentation We report a 58-year-old female with immediate, reproducible IgE-mediated adverse reactions to olaparib tablets with implementation of a 1-day novel desensitization protocol to olaparib. Following desensitization, the patient was successfully transitioned from olaparib capsules to tablets with no loss of tolerance. Conclusions To our knowledge, this is the first reported case of successful olaparib desensitization using a novel 1-day desensitization protocol, and will contribute to drug allergy knowledge, in an area where robust data is lacking. This case demonstrates the important role for drug desensitization in patients with immediate hypersensitivity reactions to chemotherapeutic agents. Furthermore, as olaparib capsules are being phased out in favour of olaparib tablets, we provide a clear case that transitioning from capsule to tablet form did not cause a loss of tolerance.

Treatment: biologics

2016 ◽  
Author(s):  
Juergen Braun ◽  
Irene E. van der Horst-Bruinsma
Keyword(s):  
Biologic Agents ◽  
Classification Criteria ◽  
New Drugs ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Biologic Treatment ◽  
Insufficient Response ◽  
Axial Disease ◽  
Inflammatory Drugs ◽  
Management Recommendations

According to classification criteria, the spectrum of spondyloarthritis (SpA) covers axial SpA (axSpA), which includes non-radiographic axSpA and ankylosing spondylitis, and peripheral SpA, which overlaps with psoriatic arthritis. Management recommendations for many forms of SpA have been recently published. Treatment of patients with axSpA with active disease starts with a sufficient dose of non-steroidal anti-inflammatory drugs (NSAIDs) for at least 4 weeks and preferably longer, in combination with exercise. In case of peripheral SpA, several disease-modifying antirheumatic drugs can be given, but these are not efficacious in axial disease. In case of insufficient response to NSAIDs for axSpA, biologic treatment can be added. The biologics most commonly used are TNF-blocking agents, but some other biologic agents seem to be beneficial in axial diseases as well, such as secukinumab (an IL-17 blocker). However, these new drugs have not yet been approved for axSpA at the time of writing this chapter.

Cyclophosphamide desensitization in patients with severe hypersensitivity reactions to bendamustine

2019 ◽  
Vol 26 (4) ◽  
pp. 982-985 ◽  
Author(s):  
Bradley Figgins ◽  
Brian Primeaux ◽  
Brandon R Shank ◽  
Sheree E Chen ◽  
Donna M Weber ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Nitrogen Mustard ◽  
Interdisciplinary Approach ◽  
Hematologic Malignancies ◽  
Hypersensitivity Reactions ◽  
Related Drug ◽  
Desensitization Protocol ◽  
Treatment Alternatives ◽  
To Receive

Introduction Cyclophosphamide is a nitrogen mustard alkylator employed in the treatment of many malignancies and autoimmune disorders. Despite reports of cyclophosphamide hypersensitivity ranging from rash to anaphylaxis, no cases of desensitization have been reported in the oncologic setting. Case report We report a cyclophosphamide desensitization protocol used for two patients who experienced severe hypersensitivity to bendamustine, a structurally related drug with potential cross immunogenicity. Management and outcome An interdisciplinary approach including immunologist, oncologist, and clinical pharmacists resulted in the development of a multi-step desensitization protocol for cyclophosphamide. The desensitization protocol described enabled the safe administration of cyclophosphamide for the two patients with limited treatment alternatives. Discussion To the authors' knowledge, this is the first report of cyclophosphamide desensitization in the oncologic setting. Two patients with advanced hematologic malignancies were able to receive cyclophosphamide with minimal adverse effects, despite experiencing previous severe hypersensitivity to another nitrogen mustard analogue.

scholarly journals Current Therapy of Rheumatoid Arthritis (part 2)

2018 ◽  
Vol 1 (2) ◽  
pp. 90
Author(s):  
Hendrata Erry Andisari
Keyword(s):  
Tumor Necrosis ◽  
Biological Agents ◽  
Current Therapy ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Conventional Dmards ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
And Control ◽  
Necrosis Factor

<p><em>Therapy in RA has undergone many advances today and in line with knowledge of the pathogenesis of RA, the current therapeutic goal is to alter the journey and control the activity of RA disease. Several groups of drugs have been used in RA therapy including non-steroidal anti-inflammatory drugs (NSAIDs), conventional disease-modifying antirheumatic drugs (DMARDs) as well as biological agents (bDMARD), glucocorticoids and anti-pain medicines. In recent years, the development of biological agents that have specific targets for inflammatory mediators such as interleukin (IL) -1, IL-6 and Tumor Necrosis Factor (TNF) suggests a potent therapeutic effect on RA. In this article will be presented the latest biological agents as the latest therapy on RA.</em></p><p> </p><strong><em>Keyword</em></strong><em>s : conventional DMARDs, biological agents</em>

A practical 16-day desensitization protocol in lenalidomide-induced non-immediate hypersensitivity reactions

2019 ◽  
Vol 123 (4) ◽  
pp. 394-397 ◽  
Author(s):  
Semra Demir ◽  
Asli Gelincik ◽  
Raif Coskun ◽  
Gulkan Ozkan ◽  
Nazli Demir ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Desensitization Protocol
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