Angioedema as a hypersensitivity reaction to polyethylene glycol oral electrolyte solution

Assal, Chafik; Watson, Peter

doi:10.1016/j.gie.2006.02.008

Cited by 15 publications

(15 citation statements)

References 6 publications

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“…MoviPrep, one of the commercial 3.35 kDa PEG solutions for colonoscopy preparation, is reported to cause hypersensitivity and rash uticaria upon administration. The low absorption rate of 0.2 % of high‐molar‐mass PEG by intestinal mucosa was suggested to be sufficient to cause angioedema as a result of systemic HSR to PEG in susceptible patients 71. Similarly, GoLYTELY, another 3.35 kDa PEG preparation for colonoscopy, was reported to cause anaphylactic reaction without prior disposition in three separate case studies 72–74…”

Section: Drawbacks Of Peg Polymersmentioning

confidence: 99%

Poly(ethylene glycol) in Drug Delivery: Pros and Cons as Well as Potential Alternatives

et al. 2010

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Poly(ethylene glycol) (PEG) is the most used polymer and also the gold standard for stealth polymers in the emerging field of polymer-based drug delivery. The properties that account for the overwhelming use of PEG in biomedical applications are outlined in this Review. The first approved PEGylated products have already been on the market for 20 years. A vast amount of clinical experience has since been gained with this polymer--not only benefits, but possible side effects and complications have also been found. The areas that might need consideration and more intensive and careful examination can be divided into the following categories: hypersensitivity, unexpected changes in pharmacokinetic behavior, toxic side products, and an antagonism arising from the easy degradation of the polymer under mechanical stress as a result of its ether structure and its non-biodegradability, as well as the resulting possible accumulation in the body. These possible side effects will be discussed in this Review and alternative polymers will be evaluated.

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Section: Drawbacks Of Peg Polymersmentioning

confidence: 99%

Poly(ethylene glycol) in Drug Delivery: Pros and Cons as Well as Potential Alternatives

et al. 2010

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“…Symptoms associated with immediate‐type PEG hypersensitivity were often severe and rapid in onset. Of the 37 cases identified, 28 (76%) described HSRs that fulfilled criteria for anaphylaxis . Common manifestations were pruritus, tingling, flushing, urticaria, angioedema, hypotension and bronchospasm.…”

Section: Literature Review Of Immediate‐type Hypersensitivity To Pegsmentioning

confidence: 99%

Immediate‐type hypersensitivity to polyethylene glycols: a review

Wenande

Garvey

2016

Clin Experimental Allergy

314

384

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Polyethylene glycols (PEGs) or macrogols are polyether compounds widely used in medical and household products. Although generally considered biologically inert, cases of mild to life-threatening immediate-type PEG hypersensitivity are reported with increasing frequency. Nevertheless, awareness of PEG's allergenic potential remains low, due to a general lack of suspicion towards excipients and insufficient product labelling. Information on immediate-type reactions to PEG is limited to anecdotal reports, and the potential for PEG sensitization and cross-sensitization to PEGylated drugs and structurally related derivatives is likely underestimated. Most healthcare professionals have no knowledge of PEG and thus do not suspect PEG's as culprit agents in hypersensitivity reactions. In consequence, patients are at risk of misdiagnosis and commonly present with a history of repeated, severe reactions to a range of unrelated products in hospital and at home. Increased awareness of PEG prevalence, PEG hypersensitivity, and improved access to PEG allergy testing, should facilitate earlier diagnosis and reduce the risk of inadvertent re-exposure. This first comprehensive review provides practical information for allergists and other healthcare professionals by describing the clinical picture of 37 reported cases of PEG hypersensitivity since 1977, summarizing instances where PEG hypersensitivity should be considered and proposing an algorithm for diagnostic management.

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“…However, the longer PEGs have been used in clinical applications, the more reports have been published regarding possible limitations of PEG in drug delivery systems 124. Oral235, 236and topical237, 238 administration may cause urticaria, nausea, gastrointestinal discomfort, and vomiting. Unpredictable complement activation after systemic application possibly leading to hypersensitivity reactions, as well as unclear pharmacokinetics after repeated administration, have been reported 239.…”

Section: The Future Has Already Begunmentioning

confidence: 99%

Polymers in Drug Delivery—State of the Art and Future Trends

2011

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Advances in biotechnology, proteomics, and genomics, as well as the deeper understanding of the molecular and cellular bases of pathophysiological states, have allowed the development of novel drugs such as proteins, peptides, and nucleic acids as therapeutic strategies of the future. Their application, however, requires sophisticated drug delivery systems which can be used to alter the pharmacokinetics and release characteristics of drugs, and to increase tissue specificity and biocompatibility. In this context, polymers provide the most promising avenue in drug release control due to their favorable, adjustable characteristics, and possibilities for further modification. Advances in the biomedical sciences have had a significant impact on the design and development of new and intelligent drug delivery systems for more controlled and targeted drug application. This review summarizes the status quo of polymer use for drug delivery with a special focus on structure–property relationships and gives overviews of various polymers, the relevant parameters in drug delivery and the most promising trends in the future.

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Angioedema as a hypersensitivity reaction to polyethylene glycol oral electrolyte solution

Cited by 15 publications

References 6 publications

Poly(ethylene glycol) in Drug Delivery: Pros and Cons as Well as Potential Alternatives

Poly(ethylene glycol) in Drug Delivery: Pros and Cons as Well as Potential Alternatives

Immediate‐type hypersensitivity to polyethylene glycols: a review

Polymers in Drug Delivery—State of the Art and Future Trends

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