title: An approach to natalizumab hypersensitivity: a case series of induction of tolerance.
abstract: Induction of tolerance protocols have been applied successfully to manage allergic reactions to many medications. Hypersensitivity reactions to natalizumab (TYSABRI®) have been recognized as a growing problem. In circumstances where a hypersensitivity reaction to a medication has occurred, but no suitable alternative exists, drug induction of tolerance protocols may be considered. Drug induction of tolerance protocols were performed in three patients with prior hypersensitivity reactions to natalizumab. All three patients tolerated the protocol without adverse reactions, allowing for the safe reintroduction of natalizumab. To conclude, this case series demonstrates success with an induction of tolerance procedure to a highly effective biological agent for multiple sclerosis, in patients with allergic reactions to natalizumab.
authors.affiliation: Department of Medicine, Division of Allergy and Clinical Immunology, Winthrop University Hospital, USA. mcamacho-halili@winthrop.org
authors.forename: Marie
authors.initials: M
authors.lastname: Camacho-Halili
authors.forename: Roxanne
authors.initials: R
authors.lastname: George
authors.forename: Malcolm
authors.initials: M
authors.lastname: Gottesman
authors.forename: Mark
authors.initials: M
authors.lastname: Davis-Lorton
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects*; D007263:Infusions, Parenteral; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; D000069442:Natalizumab