Hypersensitivity Reactions from Excipients in Systemic Glucocorticoid Formulations

Area of Science:

• Immunology
• Pharmacology
• Allergy

Background:

• Glucocorticoids are primary treatments for hypersensitivity reactions.
• Both glucocorticoids and formulation excipients can cause immediate-type hypersensitivity.
• Excipient-induced reactions are often IgE-mediated.

Purpose of the Study:

• To highlight the potential for hypersensitivity reactions to glucocorticoid formulations.
• To emphasize the role of excipients in these allergic responses.
• To recommend comprehensive allergy work-up protocols.

Main Methods:

• Review of clinical observations and immunological studies on corticosteroid hypersensitivity.
• Identification of specific IgE antibodies to common excipients like carboxymethylcellulose and lactose.
• Analysis of diagnostic approaches for immediate-type hypersensitivity.

Main Results:

• Immediate-type hypersensitivity reactions to corticosteroid drugs are well-documented.
• Specific IgE antibodies confirm excipient-induced allergic reactions.
• Common excipients such as carboxymethylcellulose and lactose can elicit IgE-mediated responses.

Conclusions:

• Hypersensitivity reactions to corticosteroid preparations can be caused by active ingredients or excipients.
• Comprehensive allergy evaluations are crucial for accurate diagnosis.
• Testing should encompass both active ingredients and excipients in corticosteroid formulations.