The experiences of ferric carboxymaltose desensitization and provocation

Fatma Dindar Çelik, MD; Kurtuluş Aksu, MD; Özgür Akkale, MD; Hatice Çelik Tuğlu, MD; Melis Yağdıran, MD; Onur Telli, MD; Gürgün Tuğçe Vural Solak, MD; Enes Çelik, MD

World Allergy Organization Journal (Feb 2025)

The experiences of ferric carboxymaltose desensitization and provocation

Fatma Dindar Çelik, MD,
Kurtuluş Aksu, MD,
Özgür Akkale, MD,
Hatice Çelik Tuğlu, MD,
Melis Yağdıran, MD,
Onur Telli, MD,
Gürgün Tuğçe Vural Solak, MD,
Enes Çelik, MD

Affiliations

Fatma Dindar Çelik, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Kurtuluş Aksu, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye; Corresponding author. Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesi, 06280, Keçiören, Ankara, Türkiye.
Özgür Akkale, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Hatice Çelik Tuğlu, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Melis Yağdıran, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Onur Telli, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Gürgün Tuğçe Vural Solak, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Immunology and Allergy, Ankara, Türkiye
Enes Çelik, MD: University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Türkiye

Journal volume & issue: Vol. 18, no. 2
p. 101025

Abstract

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Background: To present the characteristics of drug hypersensitivity reactions (DHR) among iron preparations and to describe the outcomes of rapid drug desensitization (RDD) and drug provocation tests (DPT) of ferric carboxymaltose (FCM). Methods: The retrospective descriptive study comprised patients with hypersensitivy to iron supplements. Low-risk according to the index reaction with iron, 10 patients underwent a 4-step DPT with FCM; an 11-step RDD protocol was administered to 21 patients not classified as low-risk. RDD success was evaluated for each cycle separately, defining successful completion as the implementation of all steps in both RDD and DPT protocols without subsequent early and/or late reactions. Results: Among the 21 patients (mean age: 41.73 ± 10.98 years, all female) hypersensitive to iron underwent FCM RDD, 20 patients (95.2%) successfully completed FCM treatment with RDD. RDD failed in only 1 patient (4.8%). The total number of desensitization cycles was 29, of which 28 (96.5%) were successful. Urticaria was the most common breakthrough hypersensitivity reaction and observed in 7 (33.3%) patients. Ten patients received FCM with DPT. The iron replacement therapy for these 10 patients was successfully completed. Urticaria developed in 2 patients after the completion of DPT. Conclusions: RDD is a dependable procedure facilitating the efficient delivery and completion of FCM treatments in patients with iron hypersensitivity. Additionally, FCM can be applied with DPT in low-risk patients.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/world-allergy-organization-journal

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