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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.
Funding
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
E-mail:
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