The complex clinical picture of side effects to biologicals

Hausmann, Oliver V; Seitz, Michael; Villiger, Peter M; Pichler, Werner J (2010). The complex clinical picture of side effects to biologicals. Medical clinics of North America, 94(4), 791-804, xi-ii. Philadelphia, Pa.: Elsevier 10.1016/j.mcna.2010.03.001

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Biologicals are proteins used as drugs. Biologicals target clearly defined molecular structures, being part of established pathogenetic pathways. Therefore, their focused mode of action seems to render them superior to classic small molecular drugs regarding "off-target" adverse drug reactions (ADR). Nevertheless, the increasing use of biologicals for the treatment of different diseases has revealed partially unexpected adverse reactions. The often direct interaction of a biological with the immune system provides a clue to most side effects, which have consequently been subclassified, based on pathogenetic principles, into 5 subtypes named alpha, beta, gamma, delta, and epsilon, reflecting overstimulation (high cytokine values, type alpha), hypersensitivity (type beta), immune deviation (including immunodeficiency, type gamma), cross-reactivity (type delta), and nonimmune mediated side effects (type epsilon). This article presents typical clinical manifestations of these subtypes of ADR to biologicals, proposes general rules for treating them, and provides a scheme for a thorough allergological workup. This approach should help in future handling of these often very efficient drugs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Hausmann, Oliver; Seitz, Michael; Villiger, Peter and Pichler, Werner Joseph

ISSN:

0025-7125

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:10

Last Modified:

06 Dec 2013 13:21

Publisher DOI:

10.1016/j.mcna.2010.03.001

PubMed ID:

20609863

Web of Science ID:

000279959000010

URI:

https://boris.unibe.ch/id/eprint/1666 (FactScience: 203525)

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