Update on Desensitization

  • Lucila Campos
  • Sahar A. Hamadi
  • Donna-Marie Lynch
  • Kathleen Marquis
  • Mariana C. CastellsEmail author
Drug Allergy (L Mayorga, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Drug Allergy


Purpose of review

Rapid drug desensitization (RDD) is a high-risk protocol that allows patients with hypersensitivity reactions to remain on first-line therapy for their underlying conditions through titration of dose increments and infusion rates. The aim of this paper is to review the most recent desensitization protocols available for drugs that are commonly used in clinical practice settings and to provide algorithms for their appropriate usage.

Recent findings

RDD protocols involve identification of phenotypes and endotypes during the initial reaction, risk stratification, skin testing, and specific biomarkers. Patients’ protocols are personalized and can increase life expectancy and quality of life.


The benefits of RDD largely outweigh the risks. All patients with hypersensitivity reactions should be evaluated for desensitization, to avoid alternatives treatments that may be less effective or intolerant patients presenting with SCARS (DRESS/SJS/TEN) are not candidates for desensitization since the mechanism of the reactions are poorly understood.


Desensitization Chemotherapy Drug hypersensitivity reactions Monoclonal antibodies Antibiotics Biomarkers Progesterone 


Compliance with ethical standards

Conflict of interest

Lucila Campos declares that she has no conflicts of interest. Sahar Hamadi declares that she has no conflicts of interest. Donna-Marie Lynch declares that she has no conflicts of interest. Kathleen Marquis declares that she has no conflicts of interest. Mariana Castells declares that she has no conflicts of interest

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lucila Campos
    • 1
    • 2
  • Sahar A. Hamadi
    • 1
  • Donna-Marie Lynch
    • 1
  • Kathleen Marquis
    • 1
  • Mariana C. Castells
    • 1
    Email author
  1. 1.Division of Rheumatology, Immunology and Allergy, Department of Medicine, Building of Transformative MedicineBWH, Harvard Medical SchoolBostonUSA
  2. 2.Clinical Immunology and Allergy DivisionUniversity of São PauloSão PauloBrazil

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