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Allergy Jul 2017This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the... (Review)
Review
Precision medicine in allergic disease-food allergy, drug allergy, and anaphylaxis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology.
This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease. Although significant progress has been made in defining endotypes for asthma, definitions of endotypes for food and drug allergy or for anaphylaxis lag behind. Progress has been made in discovery of biomarkers to guide a precision medicine approach to treatment of food and drug allergy, but further validation and quantification of these biomarkers are needed to allow their translation into practice in the clinical management of allergic disease.
Topics: Age of Onset; Allergens; Anaphylaxis; Biomarkers; Comorbidity; Drug Hypersensitivity; Food Hypersensitivity; Humans; Hypersensitivity; Phenotype; Precision Medicine; Severity of Illness Index
PubMed: 28122115
DOI: 10.1111/all.13132 -
British Journal of Clinical Pharmacology May 2011The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug... (Review)
Review
The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular nondepolarizing agents, sex factors, Stevens Johnson syndrome and toxic epidermal necrolysis. Additional studies were identified from article reference lists. Relevant, peer-reviewed original research articles, case series and reviews were considered for review. Current epidemiological studies on adverse drug reactions (ADRs) have used different definitions for ADR-related terminology, often do not differentiate immunologically and non-immunologically mediated drug hypersensitivity, study different study populations (different ethnicities, inpatients or outpatients, adults or children), utilize different methodologies (spontaneous vs. non-spontaneous reporting, cohort vs. case-control studies), different methods of assessing drug imputability and different methods of data analyses. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. HLA associations for SCAR associated with allopurinol, carbamazepine and abacavir have been reported with the potential for clinical use in screening prior to prescription. Identification of risk factors for drug allergy and appropriate genetic screening of at-risk ethnic groups may improve the outcomes of drug-specific SCAR. Research and collaboration are necessary for the generation of clinically-relevant, translational pharmacoepidemiological and pharmacogenomic knowledge, and success of health outcomes research and policies on drug allergies.
Topics: Adolescent; Adverse Drug Reaction Reporting Systems; Ambulatory Care Facilities; Child; Drug Hypersensitivity; Emergency Service, Hospital; Genetic Predisposition to Disease; Hospitalization; Humans; Risk Factors
PubMed: 21480948
DOI: 10.1111/j.1365-2125.2010.03774.x -
Nihon Rinsho. Japanese Journal of... Jan 2002
Review
Topics: Databases, Factual; Drug Hypersensitivity; Humans; Internet
PubMed: 11838181
DOI: No ID Found -
Immunology and Allergy Clinics of North... Aug 2014Hypersensitivity reactions to excipients contained in drugs are rare but can be severe or confusing. With regard to generic versus brand drug, often the ingredients are... (Review)
Review
Hypersensitivity reactions to excipients contained in drugs are rare but can be severe or confusing. With regard to generic versus brand drug, often the ingredients are different; for each DHR, we recommend that the physician exercises caution in considering which brand drug or generic was administered and in listing all medicine components and not only the active drug.
Topics: Drug Hypersensitivity; Excipients; Humans
PubMed: 25017684
DOI: 10.1016/j.iac.2014.04.006 -
Allergy Oct 2011Adverse drug reactions (ADR) can result from immune-mediated (drug allergy) and nonimmune-mediated mechanisms. In both types of reaction, conclusive diagnosis and... (Review)
Review
Adverse drug reactions (ADR) can result from immune-mediated (drug allergy) and nonimmune-mediated mechanisms. In both types of reaction, conclusive diagnosis and appropriate management remain major problems in daily clinical practice. This review summarizes the potentials and shortcomings of the currently available in vitro tests in the diagnosis of immediate (mostly IgE mediated) and nonimmediate (mostly T-cell mediated) drug allergy, particularly quantification of specific IgE, flow-assisted analysis of in vitro activated lymphocytes and basophils and the enzyme-linked immunosorbent spot.
Topics: Antibody Specificity; Basophils; Biomarkers; Cytokines; Drug Hypersensitivity; Humans; Immunoassay; Immunoglobulin E; Lymphocyte Activation; Lymphocytes
PubMed: 21645014
DOI: 10.1111/j.1398-9995.2011.02661.x -
Clinical Reviews in Allergy & Immunology Jun 2022Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions... (Review)
Review
Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective method to reintroduce both chemotherapeutic agents safely. Skin testing is the primary diagnostic tool used to risk-stratify patients after initial HSRs, with more widespread use for platinum agents than taxanes. Different practices exist around the use of skin testing, drug challenge, and choice of desensitization protocol. Here, we review the epidemiology, mechanism, and clinical presentation of HSRs to platinum and taxane agents, as well as key controversies in their evaluation and management.
Topics: Antineoplastic Agents; Desensitization, Immunologic; Drug Hypersensitivity; Female; Humans; Neoplasms; Platinum; Skin Tests; Taxoids
PubMed: 34338975
DOI: 10.1007/s12016-021-08877-y -
Annals of Allergy, Asthma & Immunology... Nov 2023Older adults have an increased risk of adverse drug reactions and negative effects associated with alternative antibiotic use. Although the number of antibiotic...
BACKGROUND
Older adults have an increased risk of adverse drug reactions and negative effects associated with alternative antibiotic use. Although the number of antibiotic allergies reported increases with age, the characteristics and outcomes of older adults receiving drug allergy assessment are unknown.
OBJECTIVE
To assess the characteristics and outcomes of drug allergy evaluations in older adults.
METHODS
We considered patients aged above or equal to 65 years enrolled in the United States Drug Allergy Registry (USDAR), a US multisite prospective cohort (January 16, 2019 to February 28, 2022). Data were summarized using descriptive statistics.
RESULTS
Of 1678 USDAR participants from 5 sites, 406 older adults aged above or equal to 65 years (37% 65-69 years, 37% 70-74 years, 16% 75-79 years, and 10% ≥80 years) received 501 drug allergy assessments. USDAR older adults were primarily of female sex (69%), White (94%), and non-Hispanic (98%). Most USDAR older adults reported less than or equal to 1 infections per year (64%) and rated their general health as good, very good, or excellent (80%). Of 296 (59%) penicillin allergy assessments in USDAR older adults, 286 (97%) were disproved. Other drug allergy assessments included sulfonamide (n = 41, 88% disproved) and cephalosporin (n = 20, 95% disproved) antibiotics. All 41 drug allergy labels in USDAR participants aged above or equal to 80 years and all 80 penicillin allergy labels in USDAR men aged above or equal to 65 years were disproved.
CONCLUSION
Older adults represented a quarter of USDAR participants but were neither racially nor ethnically diverse and were generally healthy without considerable antibiotic need. Most older adults presented for antibiotic allergy assessments, the vast majority of which were disproved. Drug allergy assessments may be underutilized in the older adults who are most vulnerable to the harms of unconfirmed antibiotic allergy labels.
Topics: Male; Humans; Female; United States; Aged; Prospective Studies; Penicillins; Anti-Bacterial Agents; Drug Hypersensitivity; Hypersensitivity
PubMed: 37557950
DOI: 10.1016/j.anai.2023.07.024 -
The Journal of Allergy and Clinical... Aug 2015Allergic reactions to drugs are a serious public health concern. In 2013, the Division of Allergy, Immunology, and Transplantation of the National Institute of Allergy...
Allergic reactions to drugs are a serious public health concern. In 2013, the Division of Allergy, Immunology, and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop on drug allergy. International experts in the field of drug allergy with backgrounds in allergy, immunology, infectious diseases, dermatology, clinical pharmacology, and pharmacogenomics discussed the current state of drug allergy research. These experts were joined by representatives from several National Institutes of Health institutes and the US Food and Drug Administration. The participants identified important advances that make new research directions feasible and made suggestions for research priorities and for development of infrastructure to advance our knowledge of the mechanisms, diagnosis, management, and prevention of drug allergy. The workshop summary and recommendations are presented herein.
Topics: Carbamazepine; Dideoxynucleosides; Drug Hypersensitivity; Gene Expression; HLA Antigens; Haptens; Humans; Immunoglobulin E; National Institute of Allergy and Infectious Diseases (U.S.); Practice Guidelines as Topic; Receptors, Antigen, T-Cell; Stevens-Johnson Syndrome; Terminology as Topic; Translational Research, Biomedical; United States; Virus Diseases
PubMed: 26254053
DOI: 10.1016/j.jaci.2015.05.027 -
The Medical Clinics of North America Jul 2010Clinicians commonly encounter patients who report to have drug allergy. In a large part, such allergy corresponds to adverse drug reactions, which are not immune... (Review)
Review
Clinicians commonly encounter patients who report to have drug allergy. In a large part, such allergy corresponds to adverse drug reactions, which are not immune mediated. The incriminated drug need not always be avoided for further therapy. On the other hand, drug allergy may manifest in many unexpected clinical pictures and thus not be recognized. There is no single standardized diagnostic test to confirm the immune-mediated mechanism and to identify the causative drug. Therefore, immune-mediated drug hypersensitivity reactions and their causative drugs have to be considered by the constellation of exposure, timing, and clinical features, including the pattern of organ manifestation. Prior experience with the drug is also an important feature. An allergologic workup with additional investigation may provide some help. Patients should be informed carefully about their drug allergy, whereby symptoms, drug that elicits reaction, modes of diagnosis of drug allergy, and possibly alternatives should be indicated in their allergy passport.
Topics: Adrenal Cortex Hormones; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Immunoglobulin E; Prescription Drugs; Risk Factors; Skin Tests; Sulfonamides; beta-Lactams
PubMed: 20609856
DOI: 10.1016/j.mcna.2010.03.006 -
Nihon Rinsho. Japanese Journal of... Nov 2009This article reviews recent progresses on the treatment, prevention and management of drug allergy. Life-threatening drug reactions, also referred to as severe cutaneous... (Review)
Review
This article reviews recent progresses on the treatment, prevention and management of drug allergy. Life-threatening drug reactions, also referred to as severe cutaneous adverse reactions (SCARs), include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug-induced hypersensitivity syndrome (DIHS) and anaphylactic type drug reaction. Accurate evaluation of the severity of drug reaction in early period must be critical to minimize the mortality. Japanese SCAR research group advocated the criteria for diagnosis and the guideline for the treatment of SJS and TEN with systemic steroid in early stage. For prevention, studies on the prevalence of the HLA genotype in SCARs due to each medicine are in progress. A financial relief system for patients by PMDA (pharmaceuticals and medical devices agency) is introduced.
Topics: Drug Hypersensitivity; Humans; Stevens-Johnson Syndrome
PubMed: 19899530
DOI: No ID Found