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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Objectives
- Rituximab: 1st oncology monoclonal antibody therapy
- Rituximab reaction
- Drug allergy
- Drug allergy in precision medicine
- How to identify and address drug allergy?
- Modern drug allergy phenotypes
- Endotypes and phenotypes
- Immediate and delayed reactions
- Mast-cell-specific receptor is crucial
- Hereditary alpha-tryptasemia
- Precision medicine
- Brown classification for drug allergies
- Tryptase: biomarker of mast cell activation
- IL-6: a biomarker of cytokine release reactions
- Biomarkers - tryptase and IL-6
- Antibiotics
- Immediate and delayed hypersensitivity
- Allergy is not forever
- Penicillin allergy evaluation
- Penicillin allergy impact
- Penicillin allergy evaluation: care continuum
- Penicillin allergy testing and management
- Delabeling
- Antibiotics skin testing
- Drug challenge
- Direct challenges in children
- Penicillin pathways
- Cephalosporin allergy pathway
- Delayed type IV hypersensitivity
- Maculopapular rash
- Severe case of Stevens-Johnson
- HLA associated drug hypersensitivity SJS/TEN/DRESS
- DRESS syndrome cohort
- Desensitization
- Characteristics of CHT agents
- Symptoms amendable to desensitization
- Biomarkers chemotherapy drugs HSR
- Taxane hypersensitivity
- Monoclonal antibodies
- Drug desensitization
- Indications and contraindications
- IgE mast cell desensitization
- Mechanism of IgE desensitization
- Desensitization principles & practice
- Chemotherapy drugs: carboplatin
- Hypersensitivity to monoclonals
- Severe breakthrough reactions
- Taxane algorithm
- Hypersensitivity reactions to taxanes
- BWH desensitization protocols
- Subcutaneous desensitization: Omalizumab
- Progesterone hypersensitivity
- Antibiotic desensitization
- Safety of desensitizations
- Monoclonals desensitizations
- Life expectancy of patients
- Desensitization to antibiotics
- Outcomes desensitizations
- Personalizing drug allergy
- New and different approaches
- Thank you!
Topics Covered
- Phenotypes, endotypes and biomarkers of drug allergy and hypersensitivity
- Evidence of management options
- Penicillin allergy impact
- Delabeling for drug allergy and hypersensitivity
- First line therapies for drug hypersensitivity and desensitization
Links
Series:
Categories:
Therapeutic Areas:
External Links
Talk Citation
Castells, M.C. (2024, September 30). Drug allergy: new knowledge [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 2, 2024, from https://doi.org/10.69645/FIXC9401.Export Citation (RIS)
Publication History
Financial Disclosures
- Disclosed commercial/financial matters include clinical trial PI for Blueprint Medicines (BLU-285 and BLU-263), Cogent Biosciences (SUMMIT trial), and Telios Pharmaceutical (TL-895).
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:00
Hello, everybody. I am
Dr. Mariana Castells.
I am the Drug Hypersensitivity
and Desensitization
Center Director
at the Brigham and
Women's Hospital,
and Dana-Farber Cancer Institute
at Harvard Medical
School here in Boston.
My role today is to
talk to you about
"Drug Allergy: New Knowledge".
0:23
Here are my disclosures.
0:27
The objectives of the
current talk are to review
current understanding of what is
known as phenotypes, endotypes,
and bio-markers of drug
allergy and hypersensitivity,
to provide evidence and
management options and
delabeling for drug allergy
and hypersensitivity,
and to address new
recommendations
for first-line therapy
which have induced
drug hypersensitivity and
allergy including
desensitization.
0:56
Rituximab is the world's first
oncology monoclonal
antibody therapy
that was started
since very early.
The sales for rituximab in
2016 included 8.58 billion,
indicating that this
was and continues
to be one of the most
popular targeted therapies.
This came as a price.
A 68-year-old male with
follicular lymphoma who's in
remission has been exposed to
rituximab for the eighth
lifetime exposure.
He has severe flushing,
sweating, chest pain.
The infusion is paused.
He's treated with
steroids, anti-histamines.
The infusion is restarted and
the symptoms recur and
become more severe.
The infusion is
then discontinued.
What happened to
the patient with
the perfect drug, with the drug
that is addressing his lymphoma?
What type of reaction is this?
This is what we are
going to talk about.
What phenotype is this ?
What is the mechanism
of the reaction?
What is underlying the reaction?
What's the endotype
of the reaction?
Do we have any bio-markers
to make and address
the diagnosis,
and what is the management
and the approach?
As you see here also,
the rituximab, new
generations of ofatumumab,
obinutuzumab are similar
molecules that have been
humanized and they also
have different
glycosylation patterns.
Despite the fact that
the new molecules
are not hybrid molecules,
they do not contain any
murine variable region,
those molecules are not
completely human and they will be
able and capable also
of inducing reactions.