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醋酸格拉替雷的即时反应:过敏诊断与脱敏方案

Immediate reactions with glatiramer acetate: Diagnosis of allergy and desensitization protocols.

作者信息

Marco-Martín Guadalupe, Tornero Pilar, Prieto Alicia, La Rotta Alejandro, Herrero Teresa, Baeza Maria Luisa

机构信息

Allergy Department Hospital General Universitario Gregorio Marañón (GM-M, PT, AP, ALR, TH, MLB); Allergy Department (GM-M), Hospital Universitario Infanta Sofía, Madrid; Allergy Department (ALR), Policlínica Miramar, Palma de Mallorca; Biomedical Research Network on Rare Diseases (U761 CIBERER) (MLB), Instituto de Salud Carlos III; and Institute for Health Research Gregorio Marañón (IIS-GM) (MLB), Hospital General Universitario Gregorio Marañón, Madrid, Spain.

出版信息

Neurol Clin Pract. 2020 Apr;10(2):170-177. doi: 10.1212/CPJ.0000000000000714.

DOI:10.1212/CPJ.0000000000000714
PMID:32309036
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7156204/
Abstract

PURPOSE OF REVIEW

Diverse adverse events have been associated with administration of glatiramer acetate (GA), mainly local reactions at the injection site. Other, less frequent generalized reactions include isolated postinjection reactions and anaphylaxis, which may lead to discontinuation of GA.

RECENT FINDINGS

Close collaboration between the allergy and neurology departments is needed to study adverse reactions to GA. The allergy study should include a detailed history and skin prick and intradermal tests with GA and, if possible, determination of specific IgE levels. Furthermore, the implication of other drugs should be ruled out.

SUMMARY

An accurate diagnosis of reactions to GA is essential if we are to confirm or rule out allergy to GA. When an allergy diagnosis is confirmed or firmly suspected based on clinical evidence, desensitization protocols are increasingly seen as safe methods for reintroduction of GA.

摘要

综述目的

多种不良事件与醋酸格拉替雷(GA)的给药相关,主要是注射部位的局部反应。其他较不常见的全身性反应包括孤立的注射后反应和过敏反应,这可能导致停用GA。

最新发现

过敏科和神经科之间需要密切合作以研究对GA的不良反应。过敏研究应包括详细的病史、用GA进行皮肤点刺和皮内试验,以及如果可能的话,测定特异性IgE水平。此外,应排除其他药物的影响。

总结

如果要确认或排除对GA的过敏,准确诊断对GA的反应至关重要。当根据临床证据确诊或强烈怀疑过敏诊断时,脱敏方案越来越被视为重新引入GA的安全方法。

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本文引用的文献

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Management of immediate hypersensitivity reaction to glatiramer acetate.醋酸格拉替雷速发型超敏反应的管理。
Eur J Dermatol. 2017 Feb 1;27(1):92-95. doi: 10.1684/ejd.2016.2907.
2
Successful Rapid Desensitization to Glatiramer Acetate in a Patient With Multiple Sclerosis.一名多发性硬化症患者成功实现对醋酸格拉替雷的快速脱敏
J Investig Allergol Clin Immunol. 2015;25(3):214-5.
3
IgE-mediated allergic reactions after the first administration of glatiramer acetate in patients with multiple sclerosis.多发性硬化症患者首次注射醋酸格拉替雷后IgE介导的过敏反应。
Int Arch Allergy Immunol. 2014;165(4):244-6. doi: 10.1159/000371418. Epub 2015 Jan 29.
4
IgE-mediated hypersensitivity reaction and desensitization to glatiramer acetate in a pediatric patient.一名儿科患者中IgE介导的超敏反应及对醋酸格拉替雷的脱敏作用
Pediatr Allergy Immunol. 2014 Dec;25(8):821-3. doi: 10.1111/pai.12267. Epub 2014 Oct 16.
5
Glatiramer acetate anaphylaxis: detection of antibodies and basophil activation test.醋酸格拉替雷过敏反应:抗体检测及嗜碱性粒细胞活化试验
J Investig Allergol Clin Immunol. 2012;22(1):65-6.
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Anaphylactic reaction after injection of glatiramer acetate (Copaxone®) in patients with relapsing-remitting multiple sclerosis.复发缓解型多发性硬化症患者注射醋酸格拉替雷(Copaxone®)后发生过敏反应。
Eur Neurol. 2011;66(6):368-70. doi: 10.1159/000334107. Epub 2011 Nov 25.
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Efficacy, safety, and cost-effectiveness of glatiramer acetate in the treatment of relapsing-remitting multiple sclerosis.醋酸格拉替雷治疗复发缓解型多发性硬化症的疗效、安全性和成本效益。
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Allergy workup in immediate-type local reactions to glatiramer acetate.对醋酸格拉替雷即刻型局部反应的过敏反应检查。
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