Abiraterone
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Abiraterone Allergic reaciton with subsequent immunological desensitisation: case report A 63-year-old man developed allergic reaction during treatment with abiraterone for prostate cancer. Subsequently, he underwent successful desensitisation with abiraterone. The man, who had a history of sleep apnea hypopnea syndrome and hypothyroidism, was diagnosed with prostate cancer and bone metastasis. Initially, he responded well to enzalutamide. As he remained asymptomatic, he was initiated on abiraterone 1000mg every 24 hours [route not stated], along with prednisone. After 4 days of the treatment, he developed a fairly symmetrically distributed micropapular rash on his trunk (predominantly the abdomen), the root of the upper limbs and both groins. He also developed axillary pruritus, although there were no visible lesions at this level. This was considered as an allergic reaction to abiraterone. The man’s treatment was discontinued. Four days later, the rash resolved with no residual lesions and minimum fine desquamation. Skin prick test was performed with negative results. Later, oral tolerance was evaluated after adding ebastine as premedication in an attempt to restart the drug with tolerance. He underwent a provocation test with abiraterone for 2 days. Ten hours after this challenge was completed, he developed a pruriginous micropapular rash on his thorax, affecting the axillas and the groins. As abiraterone was firstchoice agent for the man, a desensitisation protocol was developed. Dextrin maltose was used as an excipient, and he was pre-medicated with ebastine and prednisone. Once the total dose was attained, prednisone was stepped down and ebastine was discontinued, continuing abiraterone. He did not experience any adverse events or problems during the desensitisation protocol, which was fully tolerated. Author comment: "We present the case of a patient with allergy to abiraterone confirmed using controlled oral challenge. The patient managed to tolerate the full dose of the drug after a slow desensitisation procedure with no reactions." Nunez-Acevedo B, et al. Safe and successful protocol for desensitization to abiraterone. Journal of Investigational Allergology and Clinical Immunology 29: 386-387, No. 5, Jan 2019. Available from: URL: http://doi.org/10.18176/jiaci.0408 803438225 - Spain
0114-9954/19/1782-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 7 Dec 2019 No. 1782
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