From the Guidelines
Yes, a hypersensitivity reaction to daratumumab faspro can cause wheezing. Daratumumab faspro is a subcutaneous formulation of daratumumab, a monoclonal antibody used to treat multiple myeloma. Hypersensitivity reactions, including wheezing, can occur during or after administration of this medication. These reactions are typically classified as infusion-related reactions (IRRs) and can range from mild to severe. According to the management of infusion reactions to systemic anticancer therapy guidelines 1, daratumumab has an incidence of infusion-related reactions (IRs) of 40%–50%, with most being mild to moderate in severity, and symptoms can include bronchospasm, which can cause wheezing. Patients receiving daratumumab faspro should be monitored for signs of hypersensitivity reactions, including respiratory symptoms like wheezing, shortness of breath, and cough. Pre-medication with antihistamines, antipyretics, and corticosteroids is typically recommended before administration to reduce the risk of these reactions, as outlined in the guidelines 1. If wheezing or other signs of hypersensitivity occur, the infusion should be interrupted immediately, and appropriate medical intervention should be provided, which may include stopping or slowing the infusion rate, symptomatic treatment, and aggressive management for more severe reactions 1. The biological mechanism involves the release of cytokines and other inflammatory mediators in response to the foreign protein, triggering an immune response that affects the respiratory system. Key considerations for management include:
- Monitoring patients for signs of hypersensitivity reactions
- Pre-medication to reduce the risk of reactions
- Immediate interruption of the infusion if signs of hypersensitivity occur
- Appropriate medical intervention for severe reactions.
From the FDA Drug Label
- The incidence of infusion related reactions is based on a group of symptoms (including hypertension, pyrexia, rash, myalgia, hypotension, blood pressure increased, urticaria, acute kidney injury, bronchospasm, face edema, hypersensitivity, rash, syncope, wheezing, eye pruritus, eyelid edema, renal failure, swelling face) related to infusion reactions which occurred within 1 day after DKd or Kd administration.
Hypersensitivity reaction to daratumumab can cause infusion-related reactions, which may include symptoms such as wheezing.
- Key symptoms of infusion-related reactions include:
- Hypertension
- Pyrexia
- Rash
- Myalgia
- Hypotension
- Urticaria
- Acute kidney injury
- Bronchospasm
- Face edema
- Hypersensitivity
- Syncope
- Wheezing 2
From the Research
Hypersensitivity Reaction to Daratumumab
- A hypersensitivity reaction to daratumumab can cause various symptoms, including respiratory issues 3.
- According to a study, a patient experiencing a hypersensitivity reaction to daratumumab presented with symptoms such as dyspnea, throat tightness, and bronchospasm, which can be associated with wheezing 3.
- Another study found that pulmonary infusion-related reaction symptoms were more common in patients who did not receive montelukast as a pre-medication for daratumumab infusions, suggesting that respiratory issues can be a part of the reaction 4.
Relationship Between Daratumumab and Wheezing
- While the studies do not directly mention wheezing as a specific symptom of a hypersensitivity reaction to daratumumab, they do report respiratory issues such as bronchospasm and dyspnea, which can be related to wheezing 3, 4.
- The use of montelukast, a leukotriene receptor antagonist, has been associated with a lower rate of infusion-related reactions, including pulmonary symptoms, suggesting that daratumumab can cause respiratory issues similar to asthma or allergic rhinitis 4.
Administration-Related Reactions with Daratumumab
- Daratumumab has been associated with administration-related reactions, including infusion-related reactions, which can occur with the highest incidence on the first infusion 5.
- Subcutaneous daratumumab has been shown to have a lower incidence of systemic reactions compared to intravenous daratumumab, but monitoring for hypersensitivity reactions is still recommended 6, 7.