title: Desensitization regimens for drug allergy: state of the art in the 21st century.
abstract: Adverse reactions to drugs are increasingly being recognized as important contributions to disease in their own right as well as impediments to the best treatment of various conditions, including infectious, autoimmune, and neoplastic maladies. Rapid drug desensitization (RDD) is an effective mechanism for safely administering important medications while minimizing or entirely circumventing such adverse reactions in sensitized patients. We reviewed the literature on RDD in the last 10 years, including our experience from the Brigham and Women's Hospital Desensitization Program with hundreds of patients desensitized to a broad variety of drugs. RDD in our programme has been uniformly successful in patients with hypersensitivity reactions to antibiotics, chemotherapeutics, and monoclonal antibodies. Any reactions that occur during desensitization are generally much less severe than the initial hypersensitivity reaction to the drug, and patients have received the full dose of the desired medication 99.9% of the time out of (796) desensitizations. To date, there have been no fatalities. RDD is a safe and highly effective method for treating sensitized patients with the optimal pharmacologic agents. Its use should be expanded, but because patient safety is paramount, protocols must be created, reviewed, and overseen by allergist-immunologists with special training and experience in modern techniques of desensitization.
authors: Drug Desensitization Unit, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors: A
authors: A
authors: Liu
authors: L
authors: L
authors: Fanning
authors: H
authors: H
authors: Chong
authors: J
authors: J
authors: Fernandez
authors: D
authors: D
authors: Sloane
authors: M
authors: M
authors: Sancho-Serra
authors: M
authors: M
authors: Castells
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000276:immunology / Q000628:therapy*; D006801:Humans; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000276:immunology; D043823:Taxoids / Q000009:adverse effects / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D043823:Taxoids