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Tocilizumab-induced anaphylactic reactions in rheumatic diseases: Consideration for clinicians with monoclonal antibody infusions

Dear Editor, Over the past decade, a number of biologic drugs have been approved for various autoimmune conditions which has revolutionized the treatment options, yet they remain the second‐line treatment because of their high cost and potential toxicity. As hypersensitivity reactions (HSRs) following the administration of these drugs are a common entity, it requires close monitoring of the patients throughout the infusion for signs and symptoms of hypersensitivity. Hardly, few anaphylactic adverse effects have been reported for tocilizumab (TCZ), and the incidence is increasing over time, as skin testing with a test dose is not performed routinely before administering these monoclonal antibodies. Herein, we present a case of Still’s disease who had a serious anaphylactic reaction after the second infusion of TCZ which required discontinuation of TCZ.