Successful rapid subcutaneous desensitization to anakinra in a case of delayed‐type hypersensitivity reaction

Abstract

Z et al. Prostaglandin D2 inhibits hair growth and is elevated in bald scalp of men with androgenetic alopecia. Sci Transl Med 2012; 4:126ra34. 6 Cohen JL. Enhancing the growth of natural eyelashes: the mechanism of bimatoprost-induced eyelash growth. Dermatol Surg 2010; 36:1361-71. 7 Glaser DA, Hossain P, Perkins W et al. Long-term safety and efficacy of bimatoprost solution 0Á03% application to the eyelid margin for the treatment of idiopathic and chemotherapy-induced eyelash hypotrichosis: a randomized controlled trial. Br J Dermatol 2015; 172:1384-94. 8 Champagne C, Taylor M, Farrant P. Permanent chemotherapyinduced nonscarring alopecia and premature ovarian failure. Clin Exp Dermatol 2015; 40:589-90.Funding sources: none.Conflicts of interest: none declared.

Successful rapid subcutaneous desensitization to anakinra in a case with a severe immediate-type hypersensitivity reaction

“…Desensitization with anakinra has previously been reported in four separate case reports in the literature (10,(13)(14)(15). Three of these cases were desensitized for a late-onset hypersensitivity reaction, and one case was desensitized for an immediate hypersensitivity reaction with anakinra (13)(14)(15). In the first reported case with an immediate-type hypersensitivity reaction (urticaria + angioedema) sensitization to anakinra was shown with skin tests, and the patient was successfully cough, wheezing, and dysphagia 5 minutes after the first dose of subcutaneous injection of anakinra (Kineret ® 0.67 mL [100 mg]; Sobi Inc., Stockholm, Sweden).…”

“…Desensitization is a safe method of re-administering a drug that causes immediate-type hypersensitivity reactions (12). Desensitization with anakinra has previously been reported in four separate case reports in the literature (10,(13)(14)(15). Three of these cases were desensitized for a late-onset hypersensitivity reaction, and one case was desensitized for an immediate hypersensitivity reaction with anakinra (13)(14)(15).…”

Desensitization to biological agents used in rheumatology

“…A recent publication proved that desensitization is a safe and cost-effective procedure [3]. Desensitization to drugs used in rheumatology such as TNF blockers , rituximab [8,15,18,19,[30][31][32][33][34][35][36][37][38][39][40][41][42], tocilizumab [43][44][45][46][47][48], IL-17 blockers (ixekizumab) [49] and anti-IL-1 (anakinra) [50][51][52][53] has been described. Most of the described procedures were performed in patients with rheumatoid arthritis [8,32] but desensitization in patients with lupus or spondyloarthropathies [24], adult-onset Still disease [43], IgG4-related disease [40] and autoinflammatory disorders [51][52][53] has also been performed with success.…”

Rapid desensitization to anakinra‐related delayed reaction: Need for a standardized protocol

“…Immunoglobulin E-mediated reactions have been reported, with positive skinprick test for anakinra, 4 while delayed reactions to anakinra are characterized by the presence of a perivascular T-lymphocyte infiltration. 5 To date, two different desensitization schemes have been published for anakinra-related delayed reactions.…”

“…In the second one, Leroy et al have used a more rapid desensitization protocol in a patient affected by adultonset Still disease. 5 Here, we propose a safe and effective 4-day rapid desensitization scheme ( Table 1) that we applied in two patients who previously experienced a severe delayed injection-site reaction to anakinra. The study protocol was approved by the local ethics committee and informed consent was obtained from the subjects enrolled.…”