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Natalizumab-related anaphylactoid reactions in MS patients are associated with HLA class II alleles

OBJECTIVES: We aimed to investigate potential associations between human leukocyte antigen (HLA) class I and class II alleles and the development of anaphylactic/anaphylactoid reactions in patients with multiple sclerosis (MS) treated with natalizumab. METHODS: HLA class I and II genotyping was perf...

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Detalles Bibliográficos
Autores principales: de la Hera, Belén, Urcelay, Elena, Brassat, David, Chan, Andrew, Vidal-Jordana, Angela, Salmen, Anke, Villar, Luisa Maria, Álvarez-Cermeño, José Carlos, Izquierdo, Guillermo, Fernández, Oscar, Oliver, Begoña, Saiz, Albert, Ara, Jose Ramón, Vigo, Ana G., Arroyo, Rafael, Meca, Virginia, Malhotra, Sunny, Fissolo, Nicolás, Horga, Alejandro, Montalban, Xavier, Comabella, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268037/
https://www.ncbi.nlm.nih.gov/pubmed/25520955
http://dx.doi.org/10.1212/NXI.0000000000000047
Descripción
Sumario:OBJECTIVES: We aimed to investigate potential associations between human leukocyte antigen (HLA) class I and class II alleles and the development of anaphylactic/anaphylactoid reactions in patients with multiple sclerosis (MS) treated with natalizumab. METHODS: HLA class I and II genotyping was performed in patients with MS who experienced anaphylactic/anaphylactoid reactions and in patients who did not develop infusion-related allergic reactions following natalizumab administration. RESULTS: A total of 119 patients with MS from 3 different cohorts were included in the study: 54 with natalizumab-related anaphylactic/anaphylactoid reactions and 65 without allergic reactions. HLA-DRB1*13 and HLA-DRB1*14 alleles were significantly increased in patients who developed anaphylactic/anaphylactoid reactions (p(M-H) = 3 × 10(−7); odds ratio [OR](M-H) = 8.96, 95% confidence interval [CI] = 3.40–23.64), with a positive predictive value (PPV) of 82%. In contrast, the HLA-DRB1*15 allele was significantly more represented in patients who did not develop anaphylactic/anaphylactoid reactions to natalizumab (p(M-H) = 6 × 10(−4); OR(M-H) = 0.2, 95% CI = 0.08–0.50), with a PPV of 81%. CONCLUSIONS: HLA-DRB1 genotyping before natalizumab treatment may help neurologists to identify patients with MS at risk for developing serious systemic hypersensitivity reactions associated with natalizumab administration.