PMID- 26751942
OWN - NLM
STAT- MEDLINE
DCOM- 20160429
LR  - 20170112
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 34
IP  - 1
DP  - 2016 Jan-Feb
TI  - Hypersensitivity reactions during treatment with biological agents.
PG  - 129-32
AB  - The recent development of biological agents, namely, anti-tumour necrosis factor 
      alpha (TNF-alpha) agents (infliximab, adalimumab and etanercept), anti- CD20 
      monoclonal antibody (rituximab) and anti-interleukin 6 receptor (IL-6R) 
      monoclonal antibody (tocilizumab), represents a major breakthrough for the 
      treatment of immune-mediated disorders. Given their structural and functional 
      differences, distinct safety profiles can be expected for each of these agents. 
      Evidence in the literature indicates that patients treated with anti-TNF-alpha agents 
      and tocilizumab are at increased risk for bacterial infections. However, an 
      increased therapeutic use of these biological agents has disclosed other 
      side-effects, including immediate hypersensitivity reactions, such as anaphylaxis 
      and urticaria. Both under-diagnosis and over-diagnosis of hypersensitivity 
      reactions to biological agents are potential problems. Thus, it is important to 
      identify these reactions and to adopt the right approach to manage them. This 
      article reviews the general aspects of adverse events during biologic treatment, 
      focusing on IgE-mediated hypersensitivity reactions to anti-TNF-alpha agents, 
      rituximab and tocilizumab, and on the tools for the diagnosis of these 
      life-threatening reactions.
FAU - Puxeddu, Ilaria
AU  - Puxeddu I
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy.
FAU - Caltran, Elena
AU  - Caltran E
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy.
FAU - Rocchi, Valeria
AU  - Rocchi V
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy.
FAU - Del Corso, Isabella
AU  - Del Corso I
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy.
FAU - Tavoni, Antonio
AU  - Tavoni A
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy.
FAU - Migliorini, Paola
AU  - Migliorini P
AD  - Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, 
      University of Pisa, Italy. paola.migliorini@med.unipi.it.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160109
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Biological Products)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Animals
MH  - Antibodies, Monoclonal, Humanized/*adverse effects/immunology
MH  - Biological Products/*adverse effects/immunology
MH  - Drug Hypersensitivity/classification/diagnosis/*etiology/immunology
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Immunologic Tests
MH  - Immunosuppressive Agents/*adverse effects/immunology
MH  - Prognosis
MH  - Risk Factors
MH  - Rituximab/*adverse effects/immunology
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors/immunology
EDAT- 2016/01/12 06:00
MHDA- 2016/04/30 06:00
CRDT- 2016/01/12 06:00
PHST- 2015/02/12 00:00 [received]
PHST- 2015/06/15 00:00 [accepted]
PHST- 2016/01/12 06:00 [entrez]
PHST- 2016/01/12 06:00 [pubmed]
PHST- 2016/04/30 06:00 [medline]
AID - 9190 [pii]
PST - ppublish
SO  - Clin Exp Rheumatol. 2016 Jan-Feb;34(1):129-32. Epub 2016 Jan 9.