Anti-CD20 Monoklonal Antikor Tedavileri ile Görülen İnfüzyon İlişkili Reaksiyonlar: Geleneksel Derleme

Abstract

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system. The objective of the treatment of MS is to prevent relapses, to delay disability and loss of brain volume. It has been shown that B cells play an important role in the progression of the disease. B cells carry the CD20 surface marker and anti-CD20 monoclonal antibodies bind to CD20 marker. Therefore, anti-CD20 monoclonal antibodies cause depletion of B cells. Due to their different chemical structures and binding sites, the cell killing mechanisms and cell surface binding rates of monoclonal antibodies also differ. Monoclonal antibody treatments are known as highly effective and well tolerated options in the treatment of MS. Rituximab and ublituximab are chimeric, ocrelizumab is humanized, and ofatumumab is a fully human antibody. The most common and outstanding adverse effect is known as infusion-related reactions, which are most commonly seen with rituximab. Infusion-related reactions observed in about 40-70% of patients receiving rituximab, 20-30% with ocrelizumab, 20-50% with ofatumumab and 40-50% with ublituximab. The grades of infusion-related reactions varies. Although it is possible to prevent certain infusion-related reactions with premedication, it is sometimes necessary to interrupt the infusion or to implement symptomatic treatment. Therefore, patients and healthcare professionals should be aware of the possibility of an infusion-related reaction. This review aims to increase the visibility of infusion-related reactions occurring with monoclonal antibody treatments and to facilitate to prevention.