Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management

Sitek, Andrea; Chiarella, Sergio E.; Pongdee, Thanai

doi:10.3389/falgy.2023.1219735

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…Several case reports describe the onset of adverse events like arthralgia after use of omalizumab. Specifically, serum sickness-like reactions have been described, as we also reported in our communication [26,32,33].…”

Section: Discussionsupporting

confidence: 70%

“…Diagnosis of hypersensitivity reactions is difficult. Non-irritating concentrations for dupilumab skin tests have not yet been established, although some case series with a limited number of patients determined concentrations of undiluted dupilumab (150 mg/mL) for skin prick test and a dilution of 1:10 in saline for intradermal testing [32]. Since, for many patients, treatment continuation is particularly important for severe asthma management, in low-risk patients such as our case, we can safely readministered the drug.…”

Section: Discussionmentioning

confidence: 87%

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Managing Severe Adverse Reactions to Biologicals in Severe Asthma

Balan,

Deleanu,

Pintea

et al. 2023

Biomedicines

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Background: The use of biological agents in the treatment of various inflammatory and malignancy conditions has expanded rapidly. However, these agents can induce hypersensitivity reactions, posing significant clinical challenges. Methods: We conducted a retrospective study that included nine patients with severe asthma who experienced hypersensitivity reactions to biological agents (omalizumab, benralizumab and dupilumab). Results: Hypersensitivity reactions to biologicals in severe asthma were observed in 9 of 68 patients treated. In five cases, treatment was stopped or changed to another available biological, and for four patients administered under close surveillance, titrated provocation or desensitization was applied. Successful desensitization was achieved in three of the patients, allowing them to continue therapy without adverse reactions. Improvements in asthma control were observed post-desensitization, leading to the reduced need for systemic steroid treatments and an increase in quality of life. Conclusions: This study highlights the importance of recognizing hypersensitivity reactions to biologicals to have an appropriate approach for patients with severe asthma. As an effective approach for patients experiencing hypersensitivity reactions to biological agents, desensitization allows treatment continuation.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 87%

Managing Severe Adverse Reactions to Biologicals in Severe Asthma

Balan,

Deleanu,

Pintea

et al. 2023

Biomedicines

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“…Several drugs, especially biologicals, have been associated with anaphylaxis [81]. Although the risks associated with these agents are overall low, hypersensitivity reactions have been described and are reported more frequently with increased use [82]. Omalizumab (anti-IgE) and reslizumab (anti-IL 5) product labels feature black box warnings for anaphylaxis.…”

Section: Drugsmentioning

confidence: 99%

“…The overall rate of anaphylaxis caused by omalizumab, reslizumab, and other biologics utilized for allergic diseases is low, occurring in approximately 0%-0.3% of patients. The overall risk of omalizumab-related anaphylaxis is approximately 0.1%-0.2% [82,83]. Checkpoint inhibitors, a promising drug class in oncology, have only rarely been associated with anaphylaxis [84].…”

Section: Drugsmentioning

confidence: 99%

Emerging and Novel Elicitors of Anaphylaxis: Collegium Internationale Allergologicum Update 2024

Treudler

2024

Int Arch Allergy Immunol

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Background: Anaphylaxis represents the most severe end of the spectrum of allergic reactions. Frequent elicitors of anaphylaxis are insects, foods, and drugs. This paper summarizes recent development with regard to emerging and novel elicitors of anaphylaxis. Summary: Food allergens on the rise include pulses (like pea, chickpea), seeds (hemp, chia), nuts (cashew), pseudograins (buckwheat, quinoa), fruits, and microalgae. Novel foods are foods that were not consumed to any significant extent in the European Union before May 1997, which includes four edible insects (mealworm, migratory locust, house cricket, and buffalo worm). Recent investigations have pointed out the risk of anaphylaxis associated with the consumption of yellow mealworm for people allergic to shellfish and house dust mites. In Europe, fire ants (mostly Solenopsis invicta) and Vespa velutina nigrithorax represent invasive species, which account for increasing numbers of anaphylactic reactions. Also, several new drugs, especially biologicals, have been associated with anaphylaxis. Key Messages: Elicitors of anaphylaxis are changing as a result of (i) increase in demand for plant-based food, (ii) introduction of novel foods, (iii) spreading of allergens by climate changes and globalization, or (iv) due to exposure to newly developed drugs.

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Omalizumab safety concerns

Pongdee,

2024

Journal of Allergy and Clinical Immunology

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Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management

Cited by 6 publications

References 39 publications

Managing Severe Adverse Reactions to Biologicals in Severe Asthma

Managing Severe Adverse Reactions to Biologicals in Severe Asthma

Emerging and Novel Elicitors of Anaphylaxis: Collegium Internationale Allergologicum Update 2024

Omalizumab safety concerns

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