{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:35:26Z","timestamp":1790796926716,"version":"4.1.0"},"reference-count":77,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:00:00Z","timestamp":1625875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Biologicals are crucial targeted therapeutic agents in oncological, immunological, and inflammatory diseases, and their use in clinical practice is broadening. In recent years, the spread of Personalized Precision Medicine has facilitated a proliferation of new treatment options, especially biologicals. Consequently, biologicals are now among the drugs that most frequently cause hypersensitivity reactions (HSRs). Patients can develop HSRs to these agents during the first\u2010lifetime exposure or after repeated exposure, and these HSRs can be potentially life\u2010threatening or limit therapeutic options. Despite the relatively high prevalence, the underlying mechanisms of these HSRs remain obscure, and the optimal management pathways are still a matter of discussion. In this Position Paper, the authors will provide evidence\u2010based recommendations for diagnosing and managing HSRs to biologicals. Additionally, the document defines unmet needs as an opportunity to shape future research.<\/jats:p>","DOI":"10.1111\/all.14984","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T14:41:33Z","timestamp":1624372893000},"page":"39-54","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Hypersensitivity reactions to biologicals: An EAACI position paper"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7884-0830","authenticated-orcid":false,"given":"Sevim","family":"Bavbek","sequence":"first","affiliation":[{"name":"Division of Immunology and Allergy Department of Chest Diseases School of Medicine Ankara University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-5416","authenticated-orcid":false,"given":"Mauro","family":"Pagani","sequence":"additional","affiliation":[{"name":"Medical Department Medicine Ward ASST di Mantova Mantova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Alvarez\u2010Cuesta","sequence":"additional","affiliation":[{"name":"Allergy Division, Former Head Ramon y Cajal University Hospital Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6451-0163","authenticated-orcid":false,"given":"Mariana","family":"Castells","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6337-6326","authenticated-orcid":false,"given":"Adile Berna","family":"Dursun","sequence":"additional","affiliation":[{"name":"Department of Immunology and Allergic Diseases Recep Tayyip Erdo\u011fan University Rize Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Hamadi","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-3578","authenticated-orcid":false,"given":"Ricardo","family":"Madrigal\u2010Burgaleta","sequence":"additional","affiliation":[{"name":"Allergy &amp; Severe Asthma Service St Bartholomew's Hospital Barts Health NHS Trust London UK"},{"name":"Drug Desensitisation Centre Catalan Institute of Oncology Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1394-0363","authenticated-orcid":false,"given":"Soledad","family":"Sanchez\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Allergy Department Complexo Hospitalario Universitario A Coru\u00f1a (CHUAC)  A Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8775-9217","authenticated-orcid":false,"given":"Alessandra","family":"Vultaggio","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Azienda Ospedaliera Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12616"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15007\u2010020\u20102550\u20101"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2014.04.008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2014.12.006"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102013\u2010004278"},{"key":"e_1_2_12_7_1","unstructured":"https:\/\/www.sign.ac.uk\/our\u2010guidelines\/sign\u201050\u2010a\u2010guideline\u2010developers\u2010handbook\/"},{"issue":"4","key":"e_1_2_12_8_1","first-page":"212","article-title":"Hypersensitivity reactions to biological drugs","volume":"24","author":"Corominas M","year":"2014","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2006.01058.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.02.018"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13132"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa074943"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.10.90"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.07.003"},{"issue":"5","key":"e_1_2_12_15_1","first-page":"66","article-title":"Overview of the clinical development of rituximab: first monoclonal antibody approved for the treatment of lymphoma","volume":"26","author":"Grillo\u2010L\u00f3pez AJ","year":"1999","journal-title":"Semin Oncol"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078155213510542"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.03.026"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.07.031"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000454808"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.08.004"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0445"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.11.75"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2013.755957"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.06.001"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2010.03.001"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2011.1468"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2017.01.012"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.12.001"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e3283464bcd"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.02.044"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12098"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.06.022"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.04.029"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1159\/000478077"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12858"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.06.014"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S163391"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12652"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02280.x"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1159\/000336839"},{"key":"e_1_2_12_41_1","first-page":"124","article-title":"Recent advances in the understanding of drug\u2010mediated infusion reactions and cytokine release syndrome","volume":"13","author":"Walker M","year":"2010","journal-title":"Curr Opin Drug Discov Devel"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2014.06.038"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2002.1n3435.x"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.06.050"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2017.03.032"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-02466-4"},{"key":"e_1_2_12_47_1","first-page":"953","article-title":"Etanercept\u2010induced injection site reactions, mechanistic insights from clinical findings and immunochemistry","volume":"137","author":"Werth VP","year":"2001","journal-title":"Arch Dermatol"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12142"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12620"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.10.008"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.09.009"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507079945"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddr.21184"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118075685.ch5"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.4161\/mabs.3.4.16293"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.363"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.04.007"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2019.04.001"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2011.06.017"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23329"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14644"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2003.00279.x"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12350"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.1.102"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61803-0"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.09.045"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40521\u2010020\u201000238\u2010y"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.08.005"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.11.021"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0552"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.06.012"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201040810"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-019-0852-8"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60247-5"},{"key":"e_1_2_12_75_1","first-page":"333","article-title":"Correlation between atopy and hypersensitivity reactions during therapy with three different TNF\u2010alpha blocking agents in rheumatoid arthritis","volume":"27","author":"Benucci M","year":"2009","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.01.009"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2016.09.002"},{"key":"e_1_2_12_78_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000436"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.14984","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/all.14984","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.14984","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T17:06:38Z","timestamp":1692723998000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.14984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,10]]},"references-count":77,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/all.14984"],"URL":"https:\/\/doi.org\/10.1111\/all.14984","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.161718382.20133527\/v1","asserted-by":"object"}]},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,10]]},"assertion":[{"value":"2021-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}