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1. Cutaneous reaction to ifosfamide plus mesna treated with desensitization challenge: a case report

Author

Ana Delgado-Prada, Julián Borrás, Roxana Farzanegan, María Cruz Torres Gorriz, Adrián Germán-Sánchez, Raquel Cervera Aznar, Isabela Raducan, Jose Vicente Castelló, Alfredo Sanchez-Hernandez, and Ernesto Enrique

Subjects
Ifosfamide plus mesna, Desensitization, Chemotherapy, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Ifosfamide is an alkylating agent used in the treatment of a wide range of tumours. Because of known side effects it is usually administered in combination with mesna, a thiol agent with uroprotective activity, to reduce them and increase the therapeutic dose. The most frequently administered regimens for ifosfamide are fractionated doses for 3 to 5 days, high-dose intravenous bolus, and continuous infusion over 24 to 72 h. Hypersensitivity reactions to ifosfamide plus mesna are not frequently described in the literature. Moreover, no reports exist concerning desensitization for this chemotherapy combination. Case presentation A 47-year-old man with stage IV renal sarcoma was treated with the combination of ifosfamide and mesna every 3 weeks in a 4-consecutive-day infusion protocol. During the second cycle of chemotherapy, he presented acute cutaneous symptoms. A 12-step desensitization protocol was proposed in view of the lack of knowledge of the possible hypersensitivity reactions to this combination of chemotherapy agents, and the multiple difficulties found during the study of the case. Conclusions The 12-step desensitization protocol was well tolerated. Therefore, it is an appropriate and safe option in the case of suspected allergy to ifosfamide plus mesna.

Published
2022
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2. Same-Day Desensitization in Patients Who Experience Their First Reaction to a Platin Agent at the Oncology Day Unit: A Pilot Study to Safely Include This Technique Within the Multidisciplinary Pathways for the Diagnosis & Management of Hypersensitivity to Platin Agents

Author

Julián Borrás Cuartero, Roxana Farzanegan Miñano, María Cruz Torres Gorriz, Adrián Germán Sánchez, Raquel Cervera Aznar, Isabela Raducan, Jose Vicente Castelló Carrascosa, Alfredo Sanchez Hernandez, and Ernesto Enrique

Subjects
Same-Day Desensitization, Rapid Drug Desensitization, drug allergy, chemotherapy allergy, platin agents, Immunologic diseases. Allergy, RC581-607
Abstract

One of the main objectives when assessing patients who react to antineoplastics must be to ensure that they receive the required treatments without delay. From January to July 2021, at the Allergy Department at the Provincial University Consortium Hospital a pilot study was performed in which those patients suspected of having suffered a type I hypersensitivity reaction (grade 1 or 2) following Brown's anaphylaxis severity grading to a platin agent at the Provincial University Consortium oncology day unit, and once the reaction was properly treated and completely resolved, were subjected to a new procedure named as Same-Day Desensitization, which consists in the reintroduction and administration of full chemotherapy dose by allergists on the same day of the reaction by following the 1 bag/10 step protocol, looking forwards to systematize same-day reexposure using Same-Day Desensitization, doing it in the safest way possible. In total, 9 oncological patients suspected of having suffered a type I hypersensitivity reaction (grade 1 or 2) to a platin agent received total dose administration the same day of the initial reaction by following Same-Day Desensitization 1 bag/10 step protocol, without presenting further reactions. The manuscript describes a new approach in the use of Rapid Drug Desensitizations in reactive oncologic patients in treatment with platin agents, presenting the first 9 cases of oncologic patients who have been submitted to this procedure.

Published
2022
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3. Factores que condicionan la pérdida de control al reducir escalones terapéuticos en el tratamiento del asma moderada-grave en la práctica clínica habitual: estudio español multicéntrico

Author

Martínez-Moragón, E., Delgado, J., Mogrovejo, S., Fernández-Sánchez, T., Jesús, Jiménez López, Ángel, Moscardó Orenes Miguel, Patricia, Prieto Montaño, Miguel, Torrecillas Toro, Begoña, Cueva Oliver, Ángel, Ferrer Torres, Purificación, González Delgado, Wilfox, Jiménez Rodríguez Teodorikez, Brian, Vila Auli, José, Zapata Yebenes Juan, Teresa, Audicana Berasategui María, Marta, Frias Jiménez, Nieves, Hurtado de Mendoza Ruibio, Marta, Velasco Azagra, Antonio, Álvarez Fernández Jose, Sara, Acero Sainz, Rosa, Blanco González M., Estela, Gómez Nieves María, Diego, Aisa Carpio, Núria, Angrill Sellés, Cristina, Berastegui García, Astrid, Crespo Lessmann, David, De La Rosa Carrillo, Jordi, Juanola Pla, Alejandra, López Giraldo, Olga, Luengo Sánchez, Carlos, Martínez Rivera, Pilar, Martínez Olondris, Xavier, Muñoz Gall, Ester, Pinto Nogués, Francisco, Planas Coimerma, Karina, Portillo Carroz, Antoni, Riba Blanch, Luisa, Rivera Ortún M., Dan, Sánchez Berenguer, Joan, Serra Batlles, Pere, Serra Mitjà, Ana, Sogo Sagardía, Lorena, Soto Retes, Joan, Valldeperas Combas, Xavier, Vila Giralte, Ignacio, Ansotegui Zubeldia, Ignacio, Antepara Ercoreca, Miguel, Herrerías Peña, Milagros, Iriberri Pascual María, Carmen, Jaca Michelena, Adolfo, Lahuerta Castro, Amaia, Laita Legarreta, Paula, Losada Llorente, Joaquina, Prieto Prieto, Vanessa, Zorrilla Lorenzo, Lidia, Alonso Gil, Pablo, García Muñoz Juan, Marisa, Marcos Durantez, Teresa, Peña Miguel, Tahar, Ahmida, Isabel, Alvarado Izquierdo María, Michael, Alwakil Olbah, Aurelio, Arnedillo Muñoz, Ignacio, García Núñez, Diego, Gutiérrez Fernández, Antonio, Letran Camacho, Luis, Fernández Pellon, Maria, Morchon Miguel Eva, Félix, Ortiz Portal, Isabela, Raducan, Antonio, Royo Prats Juan, Dolores, Salvador Segarra María, Frederic, Tatay Soler, Alberto, Levy Naon, Pedro, Galindo Bonilla, Luis, Gil Muñoz Francisco, Patricia, Mata Calderón, Manuel, Entrenas Costa Luis, Marina, Blanco Aparicio, Manuel, García Pazos Jose, Vanessa, García Paz, Francisco-Javier, González Barcala, Pilar, Iriarte Sotes, Jorge, Marcos Rodríguez Pedro, Fernando, Molina Nieto, Ramón, Nuñez Orjales, Carracedo, Sevillano Martín, Juan, Suárez Antelo, Julia, Tábara Rodríguez, Santiago, Aparicio Español, Carlos, Sabadell Nieto, Gladis, Sabater Talaverano, Mar, Escribano Rodríguez M., Fernando, Florido López José, Ángeles, Lara Jiménez María, José, Rojas Vílchez María, Susana, Chic Palacín, Silvia, Dorronsoro Quintana, Antonio, Navarro Echeverria Jose, Eduardo, Figueroa de la Guardia, Belén, Hinojosa Jara, Victoria, Moreno García, Lucía, Valverde Vazquez, Joaquín, Cegoñino de Sus, Santonio, Compaired Villa Jose, Alfonso, Almagro López Juan, Eduardo, Arcalá Campillo, María, Cruz Molina Jose, Dolores, Soto Venegas Antonia, Patricia, Benito Martínez, Begoña, Blanco Reinosa, Beatriz, Fernández Parra, Domingo, Fernández García, Virginia, Serrano Gutiérrez, Adolfo, Velez Ruiz de Lobera, Silvia, Lara Alcon, Francisco, Carballada González, Teresa, González Fernández, Joaquín, Martín Lázaro, Noemí, Mengual Macenlle, Soledad, Alonso Viteri, Darío, Antolín Amerigo, Irina, Bobolea, Puerto, Cano Aguirre M. del, Remedios, Cardenas Contreras, Fernando, Carrillo Arias, Mercedes, Cimarra Álvarez, Belén, De Higes Martínez Eva, Magdalena, Díaz Campos Rocío, Mar, Gandolfo Cano María del, Leticia, García Rodríguez, Andrés, García Romero de Tejada Jose, Eloina, González Mancebo, Emma, González Seco, Fernando, González Torralba, Aythamy, Henríquez Santana, Lys, Herráez Herrera Pilar de, Ruth, Herrero Mosquete María, Pedro, Landete Rodríguez, Belén, López-Muñiz Ballesteros, Ester, Mohedano Vicente, Beatriz, Morales Chacón, Antonio, Moreno Fernández, Esther, Muñoz García, Elena, Ojeda Castillejo, Fernando, Pedraza Serrano, Yesenia, Peña Acevedo Acevedo, Raquel, Pérez Rojo, Natividad, Quílez Ruiz-Rico, Ángela, Ramos Pinedo, Beatriz, Rodríguez Jiménez, Mercedes, Rodríguez Rodríguez, Ana, Rosado Ingelmo, Antonio, Ruiz Peña, José, Sánchez González María, Jesús, Trujillo Trujillo María, Laura, Vázquez Fuertes, Concepción, Vila Albelda, Alexandra, Yago Meniz, Ismael, Aguilar Perez Grovas Ricardo, José, Alcázar Ramírez Alcázar Ramírez, Manuel, Barceló Muñoz José, Miguel, Bentabol Manzanares, Gustavo, De Luiz Martínez, Francisco, Linde de Luna, Alfonso, Miranda Paez, Ezequiel, Ortega Sáenz de Tejada, Alicia, Padilla Galo, Manuel, Pérez Estrada Cornejo, Carmen, Soria Esojo, Francisco, Abellán Alemán Ángel, Consuelo, Alcalde Rumayor María, Rubén, Andújar Espinosa, Roberto, Bernabeu Mora, Javier, Campano Lancharro Francisco, Tamara, Gutiérrez Urra, Sonia, Herrero Martín, Alfredo, Resano Lizaldre, and Raquel, Dacal Quintas

Published
2020
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4. Efficacy of subcutaneous house dust mite immunotherapy in patients with moderate to severe allergic rhinitis

Author

Antonio Valero, Ethel Ibáñez-Echevarría, Carmen Vidal, Isabela Raducan, José Vicente Castelló Carrascosa, and Jaime Sánchez-López

Subjects
Adult, Sublingual Immunotherapy, allergic rhinitis, Dermatophagoides pteronyssinus, Pyroglyphidae, Immunology, Dust, Allergens, Rhinitis, Allergic, Treatment Outcome, Oncology, subcutaneous immunotherapy, Desensitization, Immunologic, allergen immunotherapy, Quality of Life, Animals, Humans, Immunology and Allergy, IgE, Antigens, Dermatophagoides, Immunotherapy, house dust mites
Abstract

Tweetable abstract Subcutaneous house dust mite allergen extract for allergic rhinitis shows efficacy after 2 months of treatment. The effect was maintained throughout the whole evaluation period (1 year). Aim: To evaluate the efficacy of subcutaneous immunotherapy (SCIT) for the treatment of allergy to house dust mites (HDM) in adults with moderate/severe allergic rhinitis (AR). Methods: Patients sensitized to HDM were randomized to SCIT plus rescue medication (Group A, n = 38) or rescue medication alone (Group B, n = 18), and assessed at baseline and 2, 6 and 12 months. Results: At month 12, Group A presented significant improvement with respect to baseline as evaluated by a visual analogue scale at three concentrations of antigen (0.1, 1 and 10 IR/ml; p < 0.0001). Group A presented significant decreases in symptom scores after 2 months of treatment, which were maintained after 1 year. After 12 months of treatment, Group A showed rescue medication consumption reductions (p < 0.001) and quality of life improvements (p < 0.0001). SCIT elicited a strong immunological response and was well tolerated. Conclusion: SCIT is efficacious for HDM allergy in patients with AR, generating a strong immunological response. Trial Registration Number: EUCTR2009-018155-16-ES (Cochrane Central Register of Controlled Trials) Plain language summary Allergic rhinitis is a common disease that can be treated by exposing the patient to small quantities of the agents triggering the allergy. In this study, allergic patients were injected with extracts of house dust mites over a period of 12 months, and the status of the patient was evaluated at the initiation of treatment and at 2, 6 and 12 months. The study showed that the allergic rhinitis symptoms improved after only 2 months of treatment with the extract and were sustained after 1 year. Also, other medication to treat the rhinitis was reduced with the treatment, and quality of life improved. Overall, the study suggests that treatment with injections of extracts of house dust mites can help patients with allergic rhinitis.

Published
2022

5. Cutaneous Reaction With Ifosfamide Plus Mesna. A Desensitization Challenge: A Case Report

Author

Ana Delgado-Prada, Julián Borrás Cuartero, Roxana Farzanegan Miñano, Maria Cruz Torres Gorriz, Adrián Germán-Sánchez, Raquel Cervera Aznar, Isabela Raducan, Jose Vicente Castelló Carrascosa, Alfredo Sanchez-Hernandez, and Ernesto Enrique Miranda

Abstract

BackgroundIfosfamide is an antineoplastic agent with alkylating activity usually administered in combination with mesna. The latter is a thiol agent with uroprotective activity that prevents side effects such as haemorrhagic cystitis or nephrotoxicity which allows the administration of higher doses of ifosfamide without unwanted secondary effects. This combined treatment can be used for a wide range of tumours such as testicular, lung, lymphoma, and in advanced solid, soft-tissue sarcomas and gynaecological tumours. Ifosfamide-mesna is administered as a continuous infusion rather than in a bolus to avoid central nervous system toxicity.Case presentation A 47-year-old man with the diagnosis of stage IV renal sarcoma who received treatment with ifosfamide-mesna every 3 weeks in a consecutive 4-day infusion protocol. However, during the second chemotherapy cycle he presented urticarial lesions. In the absence of scientific evidence for risk of immediate reactions with this association, and given the lack of described experiences of allergic reactions with this chemotherapy combination, the aggressiveness of the tumour process, and the absence of validated skin tests, we proposed the completion of a 12-step desensitisation protocol.Conclusion The 12-step desensitisation protocol was well tolerated. Therefore, it is an appropriate and safe option in the case of suspected allergy to ifosfamide plus mesna. Keywords Ifosfamide plus mesna, desensitization, chemotherapy

Published
2022

6. Recent Patents for the Treatment of Asthma

Author

David El-Qutob and Isabela Raducan

Subjects
medicine.medical_specialty, Phosphodiesterase Inhibitors, Anti-Inflammatory Agents, Asthma management, Anti-asthmatic Agent, Patents as Topic, Drug Discovery, medicine, Animals, Humans, Immunology and Allergy, Anti-Asthmatic Agents, Intensive care medicine, Bronchial obstruction, Lung, Asthma, business.industry, Toll-Like Receptors, Airway inflammation, General Medicine, medicine.disease, Bronchodilator Agents, Drug development, Pharmacogenomics, Cytokines, Leukotriene Antagonists, Inflammation Mediators, business, Signal Transduction
Abstract

BACKGROUND Despite adequate adherence and completion of anti-asthmatic treatment, many patients remain poorly controlled or uncontrolled. Asthma management is based on the use of medication to reverse the bronchial obstruction and eliminate the airway inflammation. New drug development is expected in the future as a consequence of discoveries in the pathophysiology and mechanisms of asthma. Currently, a good and effective set of treatments is available for these diseases. However, the search for new treatment modalities to improve the currently available is especially important for those patients unresponsive to current therapy. OBJECTIVE In this review, we summarize new anti-cytokines therapies, anti-leucotrienes molecules, immunomodulatory and anti-inflammatory agents, researched for treatment of asthma. METHOD Database patents were used for searching new patents from 2015 and from the beginning of 2016 about treatment of asthma. CONCLUSION Pharmacogenomic point of view is now being considered by most major pharmaceutical companies as line of investigation without end in the nearest horizon. Pharmacogenomics has the potential to notably improve the safety and effectiveness of medications.

Published
2016

7. Generalized urticaria caused by ingestion of sweet potato cake

Author

David El-Qutob, Isabela Raducan, Miriam Castillo, and Fernando Pineda

Subjects
medicine.medical_specialty, business.industry, medicine, Immunology and Allergy, Urticaria pigmentosa, Ingestion, General Medicine, business, medicine.disease, Dermatology
Published
2018

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