Evidence map›Paper›PMID 42755765›Full record

ArticleFrontiers in allergy2026

Clinical phenotypes, endotypes, and biomarker profiles of immediate rituximab hypersensitivity reactions: a prospective pharmacovigilance study.

Narapong Yotinnoratham, Wannada Laisuan, Kumutnart Chanprapaph, Silada Kanokrungsee, Chavachol Setthaudom, Supornchai Onpun, Pungjai Mongkolpathumrat, Supranee Buranapraditkun, Apinya Chungcharoenpanich, Nichapha Dechapaphapitak and 5 more

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Article in Frontiers in allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Narapong YotinnorathamDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Wannada LaisuanDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Kumutnart ChanprapaphDivision of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Silada KanokrungseeDepartment of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Chavachol SetthaudomImmunology Laboratory, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Supornchai OnpunImmunology Laboratory, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pungjai MongkolpathumratDivision of Allergy and Clinical Immunology, Department of Medicine, Center of Excellence for Skin and Allergy Research, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Supranee BuranapraditkunDivision of Allergy and Clinical Immunology, Department of Medicine, Center of Excellence for Skin and Allergy Research, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Apinya ChungcharoenpanichDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Nichapha DechapaphapitakDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Supa OnchamDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Nattakirana TongdeeDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Sananya KhamkaewDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ratchaya LertnawapanDepartment of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Jettanong KlaewsongkramDivision of Allergy and Clinical Immunology, Department of Medicine, Center of Excellence for Skin and Allergy Research, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Rituximab (RTX) has been associated with immediate hypersensitivity reactions (HSRs) involving multiple phenotypes and endotypes. Objective: To characterize the clinical phenotypes and endotypes of immediate RTX HSRs. Methods: A prospective study was conducted as part of a pharmacovigilance program from July 2020 to December 2021. Participants who experienced immediate RTX HSRs were enrolled. Skin testing, basophil activation testing (BAT), IFN- Results: Seventeen patients with immediate RTX reaction were enrolled, including 9 with infusion-related reactions (IRRs) and 8 with immediate RTX HSRs. Among 13 patients who underwent biomarkers testing, all 5 patients with IRRs showed negative result for all biomarkers. Among the eight patients with immediate RTX HSRs, elevated serum tryptase levels during acute reaction onset were observed in four patients, suggesting possible type I reaction, although definite classification was limited by the reaction. Two of the 8 patients demonstrated elevated IL-6 levels together with increased serum tryptase levels, suggesting mixed reactions (type I/CRS). The remaining 4 patients could not be assigned to a specific endotype and were therefore categorized as unclassified. BAT results were negative in all cases. Conclusion: Immediate RTX HSRs demonstrated heterogeneous phenotypes and endotypes. IRRs were the most common phenotype and occurred exclusively during the first RTX cycle. Skin testing, ADA detection, and serum IL-6 measurement may contribute to endotype characterization, although larger prospective studies are needed to establish their diagnostic utility.

Indexed as

anaphylaxisbiologiccytokine release syndromehypersensitivityinterleukin-6mixed reactionmonoclonal antibodyphenotype

Identifiers

PMID42755765
PMCPMC13581838

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.