Infusion reactions to rituximab administration: algorithm of management

Background. Allergic reactions to rituximab, which have been used for the past 20 years, are common in 32–62 % of patients. The purpose of the study: to develop an algorithm for controlling adverse reactions that occur during the introduction of rituximab. Materials and methods. The personal experie...

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Main Authors: D.D. Ivanov, I.М. Zavalna
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2022-06-01
Series:Počki
Subjects:
Online Access:https://kidneys.zaslavsky.com.ua/index.php/journal/article/view/364
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author D.D. Ivanov
I.М. Zavalna
author_facet D.D. Ivanov
I.М. Zavalna
author_sort D.D. Ivanov
collection DOAJ
description Background. Allergic reactions to rituximab, which have been used for the past 20 years, are common in 32–62 % of patients. The purpose of the study: to develop an algorithm for controlling adverse reactions that occur during the introduction of rituximab. Materials and methods. The personal experience of treatment of 46 patients with various kidney diseases who received rituximab according to the indications according to the established diagnosis was analyzed. Evaluation of infusion allergic reactions was performed according to P.М. Kasi et al. (2012) for 5 classes of side effects. Results. It was found that allergic reactions to ritu­ximab occurred in 46 % of patients in the range from 1 to 4 classes. The probability of their occurrence according to the class was almost the same, but somewhat less documented for the 4th grade. Re-administration of diphenhydramine, methylprednisolone 125 mg or hydrocortisone 125 mg, if necessary salbutamol, oxygen allowed to eliminate most of the reaction, and then resumed the introduction of rituximab, starting from 25 mg/h, gradually increasing to 300 mg/h. This administration, performed 1–2 times, was effective in 1–3 classes of allergic reactions. For fourth grade, one patient required omalizumab. Generalized experience allowed to give a graphical and descriptive algorithm of actions in case of infusion side effects for rituximab. Conclusions. Based on special data and literature analysis, an algorithm for controlling infusion allergic reactions with intravenous rituximab was formulated.
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spelling doaj.art-33170a1226884d6395ff1dd0e9e8c12e2023-06-05T18:11:14ZengZaslavsky O.Yu.Počki2307-12572307-12652022-06-01112818510.22141/2307-1257.11.2.2022.364364Infusion reactions to rituximab administration: algorithm of managementD.D. Ivanov0https://orcid.org/0000-0003-2609-0051I.М. Zavalna1https://orcid.org/0000-0002-5541-7351Shupyk National Healthcare University of Ukraine, Kyiv, UkraineShupyk National Healthcare University of Ukraine, Kyiv, UkraineBackground. Allergic reactions to rituximab, which have been used for the past 20 years, are common in 32–62 % of patients. The purpose of the study: to develop an algorithm for controlling adverse reactions that occur during the introduction of rituximab. Materials and methods. The personal experience of treatment of 46 patients with various kidney diseases who received rituximab according to the indications according to the established diagnosis was analyzed. Evaluation of infusion allergic reactions was performed according to P.М. Kasi et al. (2012) for 5 classes of side effects. Results. It was found that allergic reactions to ritu­ximab occurred in 46 % of patients in the range from 1 to 4 classes. The probability of their occurrence according to the class was almost the same, but somewhat less documented for the 4th grade. Re-administration of diphenhydramine, methylprednisolone 125 mg or hydrocortisone 125 mg, if necessary salbutamol, oxygen allowed to eliminate most of the reaction, and then resumed the introduction of rituximab, starting from 25 mg/h, gradually increasing to 300 mg/h. This administration, performed 1–2 times, was effective in 1–3 classes of allergic reactions. For fourth grade, one patient required omalizumab. Generalized experience allowed to give a graphical and descriptive algorithm of actions in case of infusion side effects for rituximab. Conclusions. Based on special data and literature analysis, an algorithm for controlling infusion allergic reactions with intravenous rituximab was formulated.https://kidneys.zaslavsky.com.ua/index.php/journal/article/view/364allergic infusion reactionsrituximabomalizumabcontrol of infusion reactions
spellingShingle D.D. Ivanov
I.М. Zavalna
Infusion reactions to rituximab administration: algorithm of management
Počki
allergic infusion reactions
rituximab
omalizumab
control of infusion reactions
title Infusion reactions to rituximab administration: algorithm of management
title_full Infusion reactions to rituximab administration: algorithm of management
title_fullStr Infusion reactions to rituximab administration: algorithm of management
title_full_unstemmed Infusion reactions to rituximab administration: algorithm of management
title_short Infusion reactions to rituximab administration: algorithm of management
title_sort infusion reactions to rituximab administration algorithm of management
topic allergic infusion reactions
rituximab
omalizumab
control of infusion reactions
url https://kidneys.zaslavsky.com.ua/index.php/journal/article/view/364
work_keys_str_mv AT ddivanov infusionreactionstorituximabadministrationalgorithmofmanagement
AT imzavalna infusionreactionstorituximabadministrationalgorithmofmanagement