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Hypersensitivity Reactions to Monoclonal Antibodies: New Approaches

  • Drug Allergy (M Audicana, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of review

Adverse reactions to monoclonal antibodies are increasing in parallel with the development of new ones. Hypersensitivity reactions related with these drugs are difficult to classify using the traditional Gell and Coombs hypersensitivity reaction classification. Monoclonal antibodies (mAbs) mainly differ from most “traditional” drugs as they are not chemical compounds, but proteins are very similar to human ones. Therefore, their metabolism, mode of action, and immunogenicity are unlike other drugs, and adverse reactions might also differ. This review focuses on the classification and underlying mechanism of the HSR induced by mAb, the available diagnostic tools, and biomarkers, as well as the therapeutic approach.

Recent findings and summary

A new classification for mAb HSR based on endotype instead of phenotypic presentation has been recently proposed. Indeed, drug provocation test has been proposed in the diagnostic algorithm of mAb HSR, similarly to other “classic” drugs. Finally, we discuss the lack of knowledge about the underlying mechanism of these HSR and other unmet needs in diagnostics.

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  1. Allergy Department, Hospital Clinic, University of Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer, Villarroel, 170, 08036, Barcelona, Spain

    Sonia Gelis MD, PhD, Jenny-Tatiana Verdesoto MD & Rosa Maria Muñoz-Cano MD, PhD

  2. Immunology Department, CDB, Hospital Clinic, University of Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain

    Mariona Pascal PhD

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  1. Sonia Gelis MD, PhD
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Gelis, S., Verdesoto, JT., Pascal, M. et al. Hypersensitivity Reactions to Monoclonal Antibodies: New Approaches. Curr Treat Options Allergy 9, 394–408 (2022). https://doi.org/10.1007/s40521-022-00318-1

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