Q:

4/3/2013
I have been asked to consult on a patient with Crohn's disease for possible Humira (adalimumab) desensitization. She has had angioedema of the tongue and urticaria after receiving this medication in the past, and has had a similar reaction to Remicade. She has had numerous other trials of other medications, which have not been effective, including Enbrel, Imuran, dapsone, colchicine, and others. I am aware that protocols exist for desensitization to monoclonal antibodies, but have not seen Humira referenced specifically in these. I did try to review Dr. Castell's book chapter that you have mentioned in previous similar posts, but it's at this time only available online in portions (i.e. most pages are not able to be viewed). Thanks for your help.

A:

Thank you for your inquiry.

You will find a desensitization protocol adalimumab (Humira) in the following reference:

Quercia O. Adalimumab desensitization after anaphylactic reaction. Annals of Allergy, Asthma, and Immunology 2011 (June); 106:547-548.

Also, this reference will give you a bibliography related to this topic.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology