PMID- 34860904
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211206
IS  - 8755-1225 (Print)
IS  - 1549-4810 (Electronic)
IS  - 1549-4810 (Linking)
VI  - 30
IP  - 5
DP  - 2014 Oct
TI  - Systemic Allergic Reaction to the GLP-1 Receptor Agonist Exenatide.
PG  - 182-186
LID - 10.1177/8755122514539462 [doi]
AB  - Objective: To report a case of systemic hypersensitivity to the glucagon-like 
      peptide-1 (GLP-1) receptor agonist exenatide used in diabetes care to provide 
      significant information within the context of postmarketing safety surveillance 
      of this new drug class. Case Summary: We report on a 52-year-old male with 
      insufficiently controlled diabetes. GLP-1 agonist treatment was indicated and the 
      patient was started on 5 to 10 microg exenatide (Byetta) twice daily, which had to be 
      stopped after 1 month due to intolerable nausea. One year later, an attempt with 
      0.6 to 1.8 mg liraglutide (Victoza) once daily was well tolerated but lacked 
      efficacy after a few months. Finally, the patient was started on 2 mg exenatide 
      (Bydureon) once weekly. Concomitant treatment included metformine 1000 mg twice 
      daily and candesartan/hydrochlorothiazide (Blopress Plus) 16/12.5 mg once daily. 
      A few hours after the second injection, local urticaria and disseminated pruritus 
      evolved and after the third injection pruritus, urticaria, and shortness of 
      breath developed, which resolved to antihistamines and corticosteroids. 
      Intradermal tests were positive for Byetta (1:1000) and Bydureon (1:100) (both 
      exenatide), while Victoza (liraglutide) was negative (1:10). Specific 
      immunoglobulin E (IgE) to the drugs was not available for testing. Discussion: An 
      objective causality assessment revealed that the adverse effect to exenatide 
      (Bydureon) was probable (Naranjo probability scale: score of 8). Consistency was 
      established through positive skin tests and the biological explanation that the 
      administration of GLP-1 receptor agonists has been associated with antibody 
      formation. Conclusion: Considering emerging use of GLP-1 receptor agonists, 
      systemic hypersensitivity should be recognized as a risk in clinical practice.
CI  - (c) The Author(s) 2014.
FAU - Steveling, Esther H
AU  - Steveling EH
AD  - University Hospital Basel, Basel, Switzerland.
FAU - Winzeler, Bettina
AU  - Winzeler B
AD  - University Hospital Basel, Basel, Switzerland.
FAU - Bircher, Andreas J
AU  - Bircher AJ
AD  - University Hospital Basel, Basel, Switzerland.
LA  - eng
PT  - Case Reports
DEP - 20140619
PL  - United States
TA  - J Pharm Technol
JT  - The Journal of pharmacy technology : jPT : official publication of the 
      Association of Pharmacy Technicians
JID - 8504643
PMC - PMC5990155
OTO - NOTNLM
OT  - GLP-1 receptor agonist
OT  - adverse reaction
OT  - allergic reaction
OT  - allergy
OT  - exenatide
OT  - hypersensitivity
OT  - postmarketing surveillance
OT  - skin tests
COIS- Declaration of conflicting interest: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2014/10/01 00:00
MHDA- 2014/10/01 00:01
PMCR- 2015/06/19
CRDT- 2021/12/03 17:27
PHST- 2021/12/03 17:27 [entrez]
PHST- 2014/10/01 00:00 [pubmed]
PHST- 2014/10/01 00:01 [medline]
PHST- 2015/06/19 00:00 [pmc-release]
AID - 10.1177_8755122514539462 [pii]
AID - 10.1177/8755122514539462 [doi]
PST - ppublish
SO  - J Pharm Technol. 2014 Oct;30(5):182-186. doi: 10.1177/8755122514539462. Epub 2014 
      Jun 19.