Safety and Outcomes of Rapid Drug Desensitization to Various Biologic Agents: A Multidisciplinary Experience
Makaleler > Tam Makale · 2026
Yazarlar: Kutay Kirdok, Elif ERTUNA, Umitcan Ates, Zuleyha Galata, Meryem I. Rem Toksoy Senturk, Ragip Fatih Kural, Ecem Ay, Eda Aslan, Turkan Dizdar Canbaz, Reyhan GÜMÜŞBURUN, Emine Nihal Mete Gokmen, Aytul Zerrin Sin
JOURNAL OF ASTHMA AND ALLERGY, SCI İndekslerine Giren Dergi, Uluslararası, Wos, 2026, cilt 19, ss .-.
DOI: 10.2147/JAA.S578075
Özet
Background: Biologic agents are widely used in clinical practice, but hypersensitivity reactions (HSRs) may limit their use. Rapid drug desensitization (RDD) allows patients to safely continue essential therapy by inducing temporary tolerance, but evidence on newer biologics such as daratumumab, brentuximab vedotin, and pertuzumab remains scarce. Methods: We retrospectively reviewed 11 patients who underwent RDD for biologic-induced HSRs between 2020 and 2024 at a tertiary allergy center. Each protocol was jointly designed by an experienced allergist and clinical pharmacist and carried out in the intensive care unit under close nurse and physician supervision. Demographic, clinical, and laboratory data, reaction grades, skin test results, premedication regimens, and breakthrough reactions (BTRs) were analyzed. Results: A total of 43 RDD cycles were performed for rituximab (n = 18), brentuximab vedotin (n = 13), daratumumab (n = 9), and pertuzumab (n = 3). Six patients underwent skin testing, two with positive results. Four patients (36%) experienced only mild cutaneous BTRs during their first RDD cycle, and no severe events occurred. The overall BTR rate per cycle was 9.3%. Extending premedication to more than 24 hours before desensitization reduced BTR frequency from 17% to 4%. Conclusion: RDD proved to be a safe and effective approach for managing HSRs to both common and less frequently used biologic agents. All patients completed treatment without discontinuation. Extended premedication period, multidisciplinary planning, and intensive care unit-based monitoring appear to enhance procedural safety and support the broader implementation of RDD in clinical allergy practice.