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Practitioner's Corner

J Investig Allergol Clin Immunol 2019; Vol. 29(5): 378-398

© 2019 Esmon Publicidad

with those published ranging from hours to several weeks [6,7].

While it is desirable to reach the therapeutic dose as soon as

possible, rapid protocols are commonly associated with a

greater risk of adverse reactions [8]. Verdu et al [9] reported

a case of desensitization to abiraterone without previous

oral challenge in a patient who experienced 2 reactions to

the drug. The authors designed a rapid 1‐day protocol. The

patient experienced mild skin rash on the thorax; therefore,

the protocol was extended to 4 days and completed with

premedication comprising antihistamines and corticosteroids.

In the case we report, we selected an intermediate protocol

in order to reach the therapeutic dose as quickly as possible

and with the minimum risk of reactions. After 10 days of

desensitization, the patient was able to tolerate the complete

dose without reactions or adverse events, and excellent

tolerance was maintained after 2 months of treatment, with

normal eosinophil counts and liver enzyme values. 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 desensitization

procedure with no reactions. It is remarkable that owing to the

desensitization protocol, abiraterone could be used to avoid the

toxicity induced by docetaxel—the alternative chemotherapy

agent in this patient—while maintaining first-line therapy. We

highlight the need for oral challenge in patients who experience

nonsevere drug reactions in order to confirm hypersensitivity

and consider our protocol to be a safe and effective option for

achieving tolerance.


The authors declare that no funding was received for the

present study.

Conflicts of Interest

The authors declare that they have no conflicts of interest.


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Manuscript received February 15, 2019; accepted for publication

April 25, 2019.

Beatriz Núñez-Acevedo


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