Natalizumab-related anaphylactoid reactions in MS patients are associated with HLA class II alleles
de la Hera, Belén (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos)
Urcelay, Elena (Hopital Purpan, Toulouse)
Brassat, David (Ruhr University, Bochum)
Chan, Andrew
Vidal-Jordana, Angela (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Salmen, Anke (St. Josef-Hospital)
Villar, Luisa Maria (Hospital Universitario Ramón y Cajal (Madrid))
Alvarez-Cermeño, José C (Hospital Universitario Ramón y Cajal (Madrid))
Izquierdo, Guillermo (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Fernández, Oscar (Hospital Regional Universitario de Málaga)
Oliver, Begoña (Instituto de Investigación Biomédica de Málaga)
Saiz, Albert (Hospital Clínic i Provincial de Barcelona)
Ara, Jose Ramón (Universidad de Zaragoza)
Vigo, Ana G.
Arroyo, Rafael
Meca-Lallana, Virginia (Hospital Universitario de la Princesa (Madrid))
Malhotra, Sunny (Hospital Universitari Vall d'Hebron)
Fissolo, Nicolás (Hospital Universitari Vall d'Hebron)
Horga, Alejandro
Montalban, Xavier (Hospital Universitari Vall d'Hebron)
Comabella, Manuel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2014
Abstract:	We aimed to investigate potential associations between human leukocyte antigen (HLA) class I and class II alleles and the development of anaphylactic/anaphylactoid reactions in patients with multiple sclerosis (MS) treated with natalizumab. HLA class I and II genotyping was performed in patients with MS who experienced anaphylactic/anaphylactoid reactions and in patients who did not develop infusion-related allergic reactions following natalizumab administration. A total of 119 patients with MS from 3 different cohorts were included in the study: 54 with natalizumab-related anaphylactic/anaphylactoid reactions and 65 without allergic reactions. HLA-DRB1*13 and HLA-DRB1*14 alleles were significantly increased in patients who developed anaphylactic/anaphylactoid reactions (p = 3 × 10 −7 ; odds ratio [OR] = 8. 96, 95% confidence interval [CI] = 3. 40-23. 64), with a positive predictive value (PPV) of 82%. In contrast, the HLA-DRB1*15 allele was significantly more represented in patients who did not develop anaphylactic/anaphylactoid reactions to natalizumab (p = 6 × 10 −4 ; OR = 0. 2, 95% CI = 0. 08-0. 50), with a PPV of 81%. HLA-DRB1 genotyping before natalizumab treatment may help neurologists to identify patients with MS at risk for developing serious systemic hypersensitivity reactions associated with natalizumab administration.
Note:	Altres ajuts: Ajuts per donar Suport als Grups de Recerca de Catalunya," sponsored by the "Agència de Gestió d'Ajuts Universitaris i de Recerca" (AGAUR), Generalitat de Catalunya
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Neurology® neuroimmunology & neuroinflammation, Vol. 1 (december 2014) , ISSN 2332-7812

DOI: 10.1212/NXI.0000000000000047
PMID: 25520955

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