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病例报告:奥瑞珠单抗治疗多发性硬化症的快速脱敏既有效又安全。

Case Report: Rapid Desensitization to Ocrelizumab for Multiple Sclerosis Is Effective and Safe.

机构信息

Faculdade Israelita de Ciências da Saúde Albert Einstein School of Medicine, São Paulo, Brazil.

Clinical Immunology and Allergy Division, University of Sao Paulo School of Medicine, São Paulo, Brazil.

出版信息

Front Immunol. 2022 Feb 9;13:840238. doi: 10.3389/fimmu.2022.840238. eCollection 2022.

Abstract

Monoclonal antibodies have become a mainstay of treatment for many inflammatory diseases and malignancies. Multiple sclerosis is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system and a common cause of disability in young adults. Ocrelizumab is a recombinant humanized monoclonal antibody that targets CD20-positive B cells and has been approved in the treatment of multiple sclerosis. Although considered safe, more than 30% of patients treated with Ocrelizumab developed infusion-related reactions, mostly regarded as mild. When severe, they can lead to a definite suspension of that drug. We present a case report of Ocrelizumab desensitization in a female patient who presented an immediate hypersensitivity reaction (urticaria and angioedema) during the first Ocrelizumab infusion. Although mechanisms involved in the response were not elucidated, the procedure occurred uneventfully and permitted first-line multiple sclerosis treatment maintenances. Desensitization should be considered a safe therapeutic option in patients with immediate hypersensitivity reactions to Ocrelizumab.

摘要

单克隆抗体已成为许多炎症性疾病和恶性肿瘤治疗的主要方法。多发性硬化症是一种中枢神经系统的慢性炎症、脱髓鞘和神经退行性疾病,也是年轻人残疾的常见原因。奥瑞珠单抗是一种针对 CD20 阳性 B 细胞的重组人源化单克隆抗体,已被批准用于多发性硬化症的治疗。虽然被认为是安全的,但超过 30%接受奥瑞珠单抗治疗的患者出现了输注相关反应,大多数被认为是轻度的。当严重时,它们可能导致该药物的明确暂停。我们报告了一例女性患者在首次接受奥瑞珠单抗输注时出现即刻过敏反应(荨麻疹和血管性水肿)的奥瑞珠单抗脱敏病例。虽然未阐明反应涉及的机制,但该过程顺利进行,并允许一线多发性硬化症治疗维持。对于对奥瑞珠单抗有即刻过敏反应的患者,脱敏应被视为一种安全的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e62e/8865367/4789cfba078e/fimmu-13-840238-g001.jpg

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