Adverse Reactions to Biologic Medications Used in Allergy and Immunology Diseases

Timothy G. Chow, Lauren E. Franzblau, David A. Khan

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: The use of biologic therapies has risen exponentially over recent years, allowing for unprecedented disease control within numerous areas of Allergy/Immunology. With this expanded use, awareness and understanding of adverse reactions to biologic agents have also increased. Recent Findings: Multiple biologic adverse reaction phenotypes have been described, but significant overlap in clinical features across phenotypes exists. Given considerable phenotypic overlap, a targeted testing approach may not always be clear, and more recent classifications focus on management decision making using tools of diagnostic challenges and rapid drug desensitizations, guiding clinicians in developing a management plan when the exact underlying mechanism is not clearly known. With increased clinical experience with omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, tezepelumab, rituximab, and TNF-inhibitors, there is a growing appreciation to the spectrum and particularities of adverse reactions to these agents which are outlined in this review. Summary: Our understanding of the clinical presentation and management of adverse reactions to biologic medications encountered in Allergy/Immunology has grown. Opportunities remain to further define optimal diagnostic and management strategies for these reactions.

Original languageEnglish (US)
Pages (from-to)195-207
Number of pages13
JournalCurrent Allergy and Asthma Reports
Issue number12
StatePublished - Dec 2022


  • Adverse reaction
  • Biologic
  • Desensitization
  • Hypersensitivity
  • Omalizumab
  • Rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine


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