Rapid Desensitization in Immediate Hypersensitivity Reaction to Drugs

Giavina‐Bianchi, Pedro; Aun, Marcelo Vívolo; Galvão, Violeta Régnier; Castells, Mariana

doi:10.1007/s40521-015-0060-2

Cited by 20 publications

(17 citation statements)

References 64 publications

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“…An example of 12-step RDD for taxane is described in Table 4. Patients with HSR grade III or with comorbidities (e.g., uncontrolled asthma and/ or significant impairment in FEV1, unstable or symptomatic coronary heart disease, and poor Eastern Cooperative Oncology Group performance status), beta-blocker users, or pregnant are indicated to follow a 16-20-step protocol on intensive care unit (Table 5) [8].…”

Section: Rapid Drug Desensitization To Taxanesmentioning

confidence: 99%

“…The general algorithm for rapid drug desensitization should be applied for mAb HSR (Fig. 4) [8]. A standard desensitization protocol to mAbs has been developed with 3 intravenous dilution bags, 12 steps, and an approximate total duration of 6 h [49].…”

Section: Rapid Drug Desensitization For Monoclonal Antibodiesmentioning

confidence: 99%

“…These symptoms have been attributed to the release of proinflammatory cytokines, interleukin-6 and TNF-α, also known as cytokine storm [8].…”

Section: Introductionmentioning

confidence: 99%

“…In the last 15-20 years, clinical and basic research has provided evidence that patients with type I and type IV reactions can be safely reexposed to their allergy through desensitization protocols ( Table 2) [8].…”

Section: Introductionmentioning

confidence: 99%

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Diagnoses and Management of Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: Reactions to Taxanes and Monoclonal Antibodies

Bonamichi-Santos

Castells

2016

Clinic Rev Allerg Immunol

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Due to the increase in utilization of chemotherapies and antibodies, drug hypersensitivity reactions have increased dramatically worldwide, preventing the use of first-line therapies and impacting patients' survival and quality of life. Some of the more frequently used medications in cancer include taxanes for ovarian, lung, breast, and prostate cancers. Monoclonal antibodies are used in the treatment of neoplastic, autoimmune, and inflammatory diseases, and their clinical applications are becoming broader. Monoclonal antibody targets include CD20, HER-2, EGFR, IL-6 receptor, TNF-α, CD30, VEGF-A, IgE, and more, and examples of immunemediated and inflammatory diseases that respond to monoclonal antibodies include rheumatoid arthritis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, psoriasis and psoriatic arthritis, Wegener's granulomatosis, microscopic polyangiitis, ankylosing spondylitis, plaque psoriasis, and asthma. Neoplastic diseases include non-Hodgkin's lymphoma, chronic lymphocytic leukemia, and colorectal, breast, gastric, and lung cancer. The clinical presentation of drug hypersensitivity reactions ranges from mild cutaneous reactions to lifethreatening symptoms including anaphylaxis. Rapid drug desensitization (RDD) has become a groundbreaking approach to the management of immediate drug hypersensitivity reactions IgE and non-IgE mediated. It is the only effective procedure that enables sensitized patients to receive the full treatment dose safely, thus representing an important advance in the patients' treatment and prognosis. The aim of this review is to provide an update on hypersensitivity reactions to commonly used monoclonal and taxanes, their clinical presentations, diagnosis, and the use of RDD for their management.

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Section: Rapid Drug Desensitization To Taxanesmentioning

confidence: 99%

Section: Rapid Drug Desensitization For Monoclonal Antibodiesmentioning

confidence: 99%

“…These symptoms have been attributed to the release of proinflammatory cytokines, interleukin-6 and TNF-α, also known as cytokine storm [8].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnoses and Management of Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: Reactions to Taxanes and Monoclonal Antibodies

Bonamichi-Santos

Castells

2016

Clinic Rev Allerg Immunol

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“…On the other hand severity of oxaliplatin induced HSR may require cessation of chemotherapy (Benedik et al, 2015). Rapid drug desensitization is considered to be the only effective procedure for overcoming HSR to first-line chemotherapy (Giavina et al, 2015). In severe chemotherapy induced anaphylactic reactions, acute management ensues with epinephrine (Intramuscular), supplemental oxygen, fluid resuscitation, steroids and bronchodilators.…”

Section: Management Of Oxaliplatin Induced Hsrmentioning

confidence: 99%

Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches

Bano

Najam²,

Qazi³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini-review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.

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Hypersensitivity Reactions to Platinum Agents and Taxanes

Tsao¹,

Young²,

Otani³

et al. 2021

Clinic Rev Allerg Immunol

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Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective method to reintroduce both chemotherapeutic agents safely. Skin testing is the primary diagnostic tool used to risk-stratify patients after initial HSRs, with more widespread use for platinum agents than taxanes. Different practices exist around the use of skin testing, drug challenge, and choice of desensitization protocol. Here, we review the epidemiology, mechanism, and clinical presentation of HSRs to platinum and taxane agents, as well as key controversies in their evaluation and management.

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Rapid Desensitization in Immediate Hypersensitivity Reaction to Drugs

Cited by 20 publications

References 64 publications

Diagnoses and Management of Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: Reactions to Taxanes and Monoclonal Antibodies

Diagnoses and Management of Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: Reactions to Taxanes and Monoclonal Antibodies

Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches

Hypersensitivity Reactions to Platinum Agents and Taxanes

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