Biologic-induced urticaria due to polysorbate 80: usefulness of prick test

Pérez-Pérez, L.; García‐Gavín, J.; Piñeiro, Benjamín; Zulaica, Á.

doi:10.1111/j.1365-2133.2011.10220.x

Cited by 40 publications

(35 citation statements)

References 9 publications

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“…Although the exact mechanism of HSR to taxanes is still elusive, the available evidence indicates that taxane moieties and their solvents could be the primary causes [15,16,17,18,19,20]. Unlike in the paclitaxel cohort, the incidences of HSR were significantly different between generic and original docetaxel in this study.…”

Section: Discussioncontrasting

confidence: 49%

A Difference in the Incidences of Hypersensitivity Reactions to Original and Generic Taxanes

et al. 2016

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Purpose: To compare incidences of hypersensitivity reaction (HSR) between original and generic taxanes including paclitaxel and docetaxel. Methods: We conducted a prospective study enrolling all patients receiving taxanes at King Chulalongkorn Memorial Hospital. Taxanes were infused accordingly to the step-wise rate escalation protocol at this hospital. Active surveillance for HSRs was performed. During the study period, there was only 1 generic brand used for each taxane. We primarily compared the incidences of HSR between original and generic drugs for each taxane. Results: During the period from January 1 to December 31, 2013, a total of 258 consecutive patients receiving taxanes were enrolled; 128 received paclitaxel, i.e. 65 and 63 in the original (Taxol) and generic arms, respectively, and 130 received docetaxel, i.e. 66 and 64 in the original (Taxotere) and generic arms, respectively. Premedication, including antihistamines and dexamethasone, was administered to all patients 30 min before taxane infusion. There were 26 (10.0%) HSR events including 24 grade 2 and 2 grade 3 HSRs. In the paclitaxel group, there were 9 (13.8%) and 7 (11.1%) HSRs in the original and generic arms, respectively (p = 0.791). In the docetaxel group, there were 9 (13.6%) and 1 (1.6%) HSRs in the original and generic arms, respectively (p = 0.017). No life-threatening symptoms or permanent discontinuation of taxanes occurred. Conclusions: In this prospective study, the incidences of HSR were similar with generic and original paclitaxel but significantly different with generic and original docetaxel.

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Section: Discussioncontrasting

confidence: 49%

A Difference in the Incidences of Hypersensitivity Reactions to Original and Generic Taxanes

et al. 2016

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“…Indeed, polysorbate 80, an excipient in omalizumab, was thought to be the culprit of anaphylactoid reactions similar to those of our patient in two asthmatic patients after more than a year of successful omalizumab therapy 3. More recently, urticaria has been reported in one patient treated with different biologic drugs approved to treat severe persistent psoriasis, all containing polysorbate 80 4. The case we report here is the first case of vaccine adverse reaction due to polysorbate 80 hypersensitivity with mechanisms which remain elusive.…”

Section: Discussionsupporting

confidence: 64%

Hypersensitivity reaction to human papillomavirus vaccine due to polysorbate 80

Badiu

Geuna²,

Heffler³

et al. 2012

Case Reports

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A 17-year-old girl reported generalised urticaria, eyelid angioedema, rhino-conjunctivitis, dyspnoea and wheezing 1 h after third intramuscular administration of quadrivalent human papilloma virus vaccine (Gardasil). She was treated with antihistamine, and corticosteroids with prompt relief of rhinitis and dyspnoea, while urticaria and angioedema lasted 24 h. Intradermal test with Gardasil, which contains polysorbate 80 (PS80), resulted positive, while skin tests with the bivalent vaccine were negative. Prick test performed with PS80 resulted positive in the patient and negative in ten healthy controls. The CD203 basophil activation test result was negative for PS80 at all the tested dilutions and specific IgE was not found. As flu vaccine was recommended, the authors skin tested two flu vaccine, one containing PS80 (Fluarix, GSK), which resulted positive and another flu vaccine with no adjuvant or preservative (Vaxigrip, Sanofi Pasteur MSD), which gave negative results. The patient then received Vaxigrip without adverse reactions.

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“…The pharmaceutical additives in each biologic preparation were different, and there were no additives included in infliximab, adalimumab, and tocilizumab that were not also included in golimumab. Although various types of hypersensitivity reactions due to polysorbate 80 have previously been reported (20-23), this additive was used in all of these biologics. However, golimumab contained the least amount of polysorbate 80 among the 4 biologics: infliximab, 0.5 mg/vial (infliximab 100 mg); adalimumab, 0.8 mg/syringe (adalimumab 40 mg/0.8 mL); tocilizumab, 0.18 mg/auto-injector (tocilizumab 162 mg); golimumab 0.075 mg/syringe (golimumab 50 mg).…”

Section: Discussionmentioning

confidence: 99%

Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

et al. 2017

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Biologics used in the treatment of rheumatoid arthritis (RA) rarely cause eosinophilia. We herein report a patient with RA being treated with infliximab, adalimumab, and tocilizumab who developed eosinophilia with skin symptoms. Interestingly, the marked eosinophilia and skin symptoms did not reappear after the patient's medication was switched to golimumab. In this case, the presence of biologics-specific antibodies suggested that immunogenicity caused the eosinophilia. Therefore, switching to a biologic with a lower immunogenicity was effective. These findings may be helpful for clinicians treating patients with biologics-induced eosinophilia.

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Biologic-induced urticaria due to polysorbate 80: usefulness of prick test

Cited by 40 publications

References 9 publications

A Difference in the Incidences of Hypersensitivity Reactions to Original and Generic Taxanes

A Difference in the Incidences of Hypersensitivity Reactions to Original and Generic Taxanes

Hypersensitivity reaction to human papillomavirus vaccine due to polysorbate 80

Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

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