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Treatment of rheumatoid arthritis with the selective costimulation modulator abatacept: Considering that it was not the aim of our study to evaluate the relationship of IIR with comorbidities, it was not possible to attribute the absence of IIR to the use of ABT due to patient characteristics; however, it should be emphasized that the existence of obstructive lung disease is a contraindication related to the use of ABT.
Av Brigadeiro Luiz Antonio, – Cj Number of indications in the package insert: Mild and transient response, no indication of interruption of the infusion; no indication of intervention. As severity, most IIR are of mild to moderate intensity.
How to cite this article. Comparison of drug retention rates and causes of drug discontinuation between anti-tumor necrosis factor agents in rheumatoid arthritis. Open label study to assess infliximab safety and timing of onset of clinical benefit among patients with rheumatoid arthritis. Low-dose glucocorticoid therapy decreases risk for treatment limiting infusion reaction to infliximab in patients with rheumatoid arthritis.
Discussion General reactions Essentially, the infusional reactions are classified in allergic IgE-mediated or of hypersensitivity type I and non-allergic non-IgE, generally attributed to cytokine release reactions. Thus, the presented results cannot be interpreted in a comparative manner between different drugs, but are significantly useful to reflect the practical treatment routine of autoimmune diseases with IV IBD.
Results of a phase II trial of rituximab. Tolerability and safety of rituximab. One added obstacle in the analysis of comparative studies is the lack of standardization of nomenclature and of the reaction classification of the series, since the designation “infusional reaction” can be found as “allergic reaction”, “acute infusional reaction”, “immediate infusional reaction” and other terms, generating a possible bias in the interpretation of results.
Unique aspects of supportive care using monoclonal antibodies in cancer treatment. In two IFX infusions, there was no recurrence of reactive symptoms after initial measures, even after required further intervention, which resulted in a successful procedure. Brief or prolonged interruption of the infusion e. Interruption of the infusion and use of rescue medication and hemodynamic support.
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We recognize that the main limitation of the combined data analysis in our study was the discrepancy among the number of IFX infusions, when compared to the other three drugs. All infusions were performed intravenously and preceded by medical evaluation. Managing premedications and the risk for reactions to infusional monoclonal antibody therapy. The form of presentation, behaviour, severity and outcomes were similar to those described in orebcia series. Original Articles Immediate infusional reactions to intravenous immunobiological agents oeencia the treatment of autoimmune diseases: For the other drugs, the dosage established by the prescribing physician was kept.
With the increasing use of immunobiological drugs IBDthe knowledge about their effectiveness and safety has increased. Discontinuation of the procedure.
RTX is a chimeric murine-human anti-CD20 monoclonal antibody originally used for the treatment of non-Hodgkin lymphoma protocols, and is also approved for the treatment of rheumatoid arthritis. Immediate infusional reaction IIR. Infusions performed from October on were evaluated, when IFX was the only available drug in Brazil. Immediate infusional reactions to intravenous immunobiological agents orejcia the treatment of autoimmune diseases: We believe that the results obtained in our study favour the infusional safety of TCZ.
As an overall result, of the procedures, only 6 0. odencia
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How to manage hypersensitivity reactions to biological agents? Single-agent monoclonal antibody efficacy in bulky non-Hodgkin’s lymphoma: As determined in previous studies and recommendations of the manufacturer, 6 infusions of RTX must be preceded by some drug preparation antihistamines, corticosteroids and acetaminophen. Study of active controlled monotherapy used for rheumatoid arthritis, an IL-6 inhibitor Samurai: Conclusions Despite a heterogeneous distribution of the number of procedures for these drugs, we believe that the results reflect the analysis of a “real life” sample, where the frequency of IIR was not higher than that described in the literature.
Compared to studies of non-Hodgkin lymphoma and leukemias, diseaser where RTX is commonly used for extended amounts of time, the knowledge about the use of this drug for autoimmune diseases is still limited.
It is also necessary to emphasize that the overall percentages of IIR observed in our study may also have been influenced by the pre-medical consultation conducted by medical staff of the Infusion Centre – CID before every infusion, with the main goal of an early detection of absolute contraindications prior to the infusion. The most common symptoms are transient elevation of blood pressure, redness at the site of venipuncture, headache, nausea and rashes.
Temporary interruption of the infusion and use of rescue medication; infusion resumed after complete resolution of symptoms.
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Tocilizumab TCZ is a recombinant humanized monoclonal antibody that blocks interleukin-6 receptor that plays a fundamental role in the pathophysiology of rheumatoid arthritis. In terms of clinical presentation, the most common reactions were purely cutaneous rash, itching, redness, urticariform lesionsdescribed in 21 IIR We emphasize that in some premedication cases its use occurred in patients who had previously suffered of IIR, which determines orenciz bias in data analysis.
IFX is a chimeric murine-human monoclonal antibody that binds to TNF tumour necrosis factorused successfully for the control of several autoimmune diseases. ABT is a fusion protein that blocks and modulates a key costimulatory signal, promoting downregulation of T cells.
Some conditions justify this finding:. Essentially, the infusional reactions are classified in allergic IgE-mediated or of hypersensitivity type I and non-allergic non-IgE, generally attributed to cytokine release reactions.
Systematic safety follow up in a cohort of patients with spondyloarthropathy treated with infliximab: In 6 infusions, all from the IFX group 7. Temporary interruption of the infusion, use of rescue medication, if necessary; infusion resumed after complete resolution of symptoms.
It is important to note that, considering the characteristics of the study, a single patient may have been subjected to more than one type of treatment. An infusion pump was only used in RTX infusions.
This protocol, developed for the treatment of lymphoma, is also adopted in the care of patients with autoimmune diseases, and has been used in infusions performed at the Infusion Centre – CID. The proportion of IIR dropped by half from the first to the fourth infusion.