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Immediate Infusion Reaction to Intravenous Risankizumab-rzaa but Subsequent Tolerance to Subcutaneous
David Choi1, Benjamin McDonald1, David T Rubin1
1University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL.
ACG Case Reports Journal
|November 7, 2024
Summary
Risankizumab-rzaa (RZA), a biologic therapy, can be safely switched to a subcutaneous formulation after a severe infusion reaction to the intravenous version. This transition demonstrates a viable option for patients experiencing hypersensitivity to IV RZA.
Area of Science:
- Immunology
- Pharmacology
- Dermatology
Background:
- Risankizumab-rzaa (RZA) is a fully human IgG monoclonal antibody (Mab) targeting IL-23.
- RZA is approved for moderate-to-severe plaque psoriasis, psoriatic arthritis, and Crohn's disease.
- Pivotal trials indicated no significant difference in infusion reactions between RZA and placebo.
Observation:
- A patient experienced a serious hypersensitivity reaction to intravenous (IV) RZA.
- The patient was successfully transitioned to subcutaneous (SC) RZA.
- No further adverse events were noted after the switch to SC administration.
Findings:
- Successful transition from IV to SC RZA is feasible in patients with hypersensitivity.
- Subcutaneous administration may mitigate risks associated with IV infusions.
- Individual patient responses to biologic therapies can necessitate formulation adjustments.
Implications:
- This case highlights a potential management strategy for patients experiencing infusion reactions to IV biologics.
- Subcutaneous RZA offers a potentially safer alternative for hypersensitive individuals.
- Further research may explore the long-term safety and efficacy of SC RZA in this patient population.
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