Best practices in multiple sclerosis: infusion reactions versus hypersensitivity associated with biologic therapies.
Infusion nurses are uniquely positioned to play a vital role in the early identification and management of infusion and hypersensitivity reactions during the administration of biologic therapies. This article reviews the current evidence regarding reactions related to the administration of monoclonal antibodies, namely, natalizumab, a humanized monoclonal antibody against the cellular adhesion molecule alpha4-integrin, in patients with multiple sclerosis. In addition to differentiating between infusion and hypersensitivity reactions, the article presents general guidelines for the management of these reactions and provides case studies to better illustrate the use of appropriate interventions.
Namey
Marie
M
Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. NAMEYM@ccf.org
Halper
June
J
O'leary
Shirley
S
Beavin
Jill
J
Bishop
Cynthia
C
D000707:Anaphylaxis / Q000209:etiology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000451:nursing; D006968:Hypersensitivity, Delayed / Q000209:etiology; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000451:nursing; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000451:nursing / Q000628:therapy*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000451:nursing / Q000628:therapy; D000069442:Natalizumab; D019462:Syncope, Vasovagal / Q000209:etiology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; D000069442:Natalizumab