Sachs B, Merk H F
Klinik für Dermatologie und Allergologie, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Abteilung Forschung, Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), Kurt-Georg Kiesinger Allee 3, 53175, Bonn, Deutschland.
Hautarzt. 2018 Apr;69(4):268-277. doi: 10.1007/s00105-018-4142-5.
The application of biologics such as monoclonal antibodies for targeted therapy may lead to immediate adverse drug reactions with different pathophysiological mechanisms. Some of them are due to the immunogenicity of these drugs and are truly allergic, some of them are non-allergic, some are on-target, and some are off-target. The main example of non-allergic reactions are infusion reactions, mainly induced by cytokine release. They generally occur already at the first application and symptoms may decrease in subsequent applications. Allergic reactions need a preceding sensitization phase and therefore may not occur at first application. However, if the IgE-mediated reaction is due to cross-reactivity, they may occur at the first application of the monoclonal antibody. The management of these reactions depends on their severity and the ultimate need to treat the patient with these drugs.
应用单克隆抗体等生物制剂进行靶向治疗可能会引发具有不同病理生理机制的即时药物不良反应。其中一些是由于这些药物的免疫原性导致的真正过敏反应，一些是非过敏反应，一些是靶向反应，还有一些是脱靶反应。非过敏反应的主要例子是输液反应，主要由细胞因子释放引起。它们通常在首次应用时就会出现，后续应用时症状可能会减轻。过敏反应需要先前的致敏阶段，因此首次应用时可能不会发生。然而，如果IgE介导的反应是由于交叉反应引起的，那么在首次应用单克隆抗体时就可能发生。这些反应的处理取决于其严重程度以及使用这些药物治疗患者的最终需求。
