Hypersensitivity reactions during treatment with biological agents

Area of Science:

• Immunology
• Pharmacology
• Clinical Medicine

Background:

• Biological agents, including anti-tumour necrosis factor alpha (TNF-α), anti-CD20, and anti-interleukin 6 receptor (IL-6R) therapies, have revolutionized immune-mediated disorder treatment.
• These agents possess distinct structures and functions, leading to varied safety profiles and potential adverse events.
• While bacterial infections are known risks, immediate hypersensitivity reactions like anaphylaxis and urticaria are increasingly recognized side-effects.

Purpose of the Study:

• To review general adverse events associated with biologic treatments.
• To focus on IgE-mediated hypersensitivity reactions to specific biologic agents: anti-TNF-α, rituximab, and tocilizumab.
• To discuss diagnostic tools for identifying these potentially life-threatening hypersensitivity reactions.

Main Methods:

• Literature review of adverse events related to biologic therapies.
• Focus on IgE-mediated hypersensitivity reactions.
• Examination of diagnostic methodologies for hypersensitivity reactions.

Main Results:

• Anti-TNF-α agents and tocilizumab are associated with an increased risk of bacterial infections.
• Hypersensitivity reactions, including anaphylaxis and urticaria, are significant adverse events of biologic therapy.
• Accurate diagnosis of hypersensitivity reactions is crucial to avoid under- or over-diagnosis.

Conclusions:

• Effective management of immune-mediated disorders with biologics requires careful monitoring for adverse events.
• Identifying and correctly diagnosing hypersensitivity reactions to biologics like anti-TNF-α, rituximab, and tocilizumab is critical.
• Appropriate diagnostic tools and management strategies are essential for patient safety during biologic treatment.