Journal of Literature Pharmacy Sciences

Infusion-Related Reactions with Anti-CD20 Monoclonal Antibody Treatments in Multiple Sclerosis: Traditional Review
Anti-CD20 Monoklonal Antikor Tedavileri ile Görülen İnfüzyon İlişkili Reaksiyonlar: Geleneksel Derleme
Cansu GÖNCÜOĞLUa, Kübra Nur ÖKSÜZOĞLUb, Aygin BAYRAKTAR EKİNCİOĞLUb
aDepartment of Clinical Pharmacy, Selçuk University Faculty of Pharmacy, Konya, Türkiye
bDepartment of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
J Lit Pharm Sci. 2022;11(3):231-40
doi: 10.5336/pharmsci.2022-92927
Article Language: EN
Full Text
ABSTRACT
 Multiple sclerosis (MS) is a chronic disease that affects the central nervous system. The objective of the treatment of MS is to prevent relapses, to delay disability and loss of brain volume. It has been shown that B cells play an important role in the progression of the disease. B cells carry the CD20 surface marker and anti-CD20 monoclonal antibodies bind to CD20 marker. Therefore, anti-CD20 monoclonal antibodies cause depletion of B cells. Due to their different chemical structures and binding sites, the cell killing mechanisms and cell surface binding rates of monoclonal antibodies also differ. Monoclonal antibody treatments are known as highly effective and well tolerated options in the treatment of MS. Rituximab and ublituximab are chimeric, ocrelizumab is humanized, and ofatumumab is a fully human antibody. The most common and outstanding adverse effect is known as infusion-related reactions, which are most commonly seen with rituximab. Infusion-related reactions observed in about 40-70% of patients receiving rituximab, 20-30% with ocrelizumab, 20-50% with ofatumumab and 40-50% with ublituximab. The grades of infusion-related reactions varies. Although it is possible to prevent certain infusion-related reactions with premedication, it is sometimes necessary to interrupt the infusion or to implement symptomatic treatment. Therefore, patients and healthcare professionals should be aware of the possibility of an infusion-related reaction. This review aims to increase the visibility of infusion-related reactions occurring with monoclonal antibody treatments and to facilitate to prevention.

Keywords: Multiple sclerosis; infusions; monoclonal antibody
ÖZET
 Multipl skleroz (MS), santral sinir sistemini etkileyen kronik bir hastalıktır. MS tedavisinin amacı; atakları önlemek, özürlülüğü ve beyin hacmi kaybını geciktirmektir. B hücrelerinin hastalığın ilerlemesinde önemli bir rol oynadığı gösterilmiştir. B hücreleri, CD20 yüzey proteinini taşımakta ve anti-CD20 monoklonal antikorları da CD20 proteinine bağlanmaktadır. Böylece anti-CD20 monoklonal antikorları B hücrelerinin tükenmesine neden olmaktadır. Farklı kimyasal yapıları ve bağlanma yerleri nedeniyle monoklonal antikorların hücre öldürme mekanizmaları ve hücre yüzeyine bağlanma oranları da farklılık göstermektedir. Monoklonal antikor tedavileri, MS tedavisinde oldukça etkin, sık tercih edilen tedavi seçenekleridir ve tolere edilebilir oldukları bilinmektedir. Rituksimab ve ublituksimab şimerik molekülken; okrelizumab insanlaştırılmış, ofatumumab ise tamamen insan antikorudur. En yaygın görülen advers etki, infüzyon ilişkili reaksiyonlardır. İnfüzyon ilişkili reaksiyonların anti-CD20 monoklonal antikorlarından en sık rituksimab ile görüldüğü bilinmektedir. Rituksimab alan hastaların %40-70'inde, okrelizumab alanların %20-30'unda, ofatumumab alanların %20-50'sinde ve ublituksimab alanların %40-50'sinde infüzyon ilişkili reaksiyonlar bildirilmiştir. Bu antikorların ortaya çıkardığı infüzyon ilişkili reaksiyonların dereceleri ise değişmektedir. Premedikasyon ile infüzyon ilişkili reaksiyonları kısmen önlemek mümkün olsa da bazı durumlarda infüzyona ara vermek veya semptomatik tedavi uygulamak gerekebilmektedir. Bu nedenle hastalar ve sağlık çalışanlarının, infüzyon ilişkili reaksiyonların farkında olması önerilmektedir. Bu derleme, monoklonal antikor tedavileri ile oluşan infüzyon ilişkili reaksiyonların görünürlüğünü artırmayı ve bu reaksiyonların önlenmesini kolaylaştırmayı amaçlamaktadır.

Anahtar Kelimeler: Multipl skleroz; infüzyonlar; monoklonal antikor
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Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com