Een praktische richtlijn voor de indeling en behandeling van overgevoeligheidsreacties bij biologicals

Background and objective Biolagicals are drugs that are designed to mimic human proteins. Nevertheless, biolagicals can cause adverse drug reactions. This literature study examines the types of adverse drug reactions that occur with biologicaIs, the actions needed to optimise safety of biologicaIs in case of adverse drug reactions, and how these reactions can be registered in electronic prescribing systems. Design and methods Evidence-based information about adverse drug reactions to biologicals was collected by a literature review. Expert opinions were added to include clinical experience and to formulate practice recommendations. Results Biologicals may cause adverse drug reactions, which can be diagnosed by phenotype, endotype, and biomarkers. Practice recommendations for the follow-up policy are based on these characteristics and the severity of the symptoms. For most reactions, re-exposure is often possible with premedication, a reduced infusion rate, or desensitisation. However, in cases of severe reactions, re-exposure should be avoided. Since most biologicals have a unique protein structure, cross-reactivity is not expected. Conclusion Adverse reactions to biologicaIs can be diagnosed based on phenotype, endotype, and biomarkers. The follow-up policy is based on the type and severity of the reaction. As there is generally no cross-reactivity, the biological that caused the reaction should be registered as the causative agent in the patient record. Adequate documentation of reactions and the transfer of information between healthcare professionals may further enhance medication safety and assure management of hypersensitivity to biologicals.