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The Journal of Allergy and Clinical... Dec 2021
Topics: Anti-Bacterial Agents; Drug Hypersensitivity; Humans; Mobile Applications; Penicillins; Smartphone
PubMed: 34893194
DOI: 10.1016/j.jaip.2021.08.015 -
Skinmed 2007
Review
Topics: Dermatitis, Phototoxic; Drug Eruptions; Drug Hypersensitivity; Humans; Skin; Sulfonamides
PubMed: 17618165
DOI: 10.1111/j.1540-9740.2007.07147.x -
Allergy Mar 2024Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for... (Review)
Review
Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. Underdiagnosis and overdiagnosis are common and due to the lack of standardized definitions and biomarkers. The true burden of DA is unknown, and recent efforts in data gathering through electronic medical records are starting to provide emerging patterns around the world. Ten percent of the general population engaged in health care claim to have a DA, and the most common label is penicillin allergy. Up to 20% of emergency room visits for anaphylaxis are due to DA and 15%-20% of hospitalized patients report DA. It is estimated that DA will increase based on the availability and use of new and targeted antibiotics, vaccines, chemotherapies, biologicals, and small molecules, which are aimed at improving patient's options and quality of life. Global and regional variations in the prevalence of diseases such as human immunodeficiency virus and mycobacterial diseases, and the drugs used to treat these infections have an impact on DA. The aim of this review is to provide an update on the global impact of DA by presenting emerging data on drug epidemiology in adult and pediatric populations.
Topics: Adult; Child; Humans; Quality of Life; Drug Hypersensitivity; Penicillins; Anti-Bacterial Agents; Anaphylaxis
PubMed: 38084822
DOI: 10.1111/all.15970 -
Journal of Immunological Methods Jun 2021
Topics: Drug Hypersensitivity; Humans
PubMed: 33684438
DOI: 10.1016/j.jim.2021.113004 -
The Medical Clinics of North America Jan 2020Drug hypersensitivity reactions (DHRs) may be classified based on timing (immediate vs delayed), mechanisms, and pattern of clinical manifestations. Management may... (Review)
Review
Drug hypersensitivity reactions (DHRs) may be classified based on timing (immediate vs delayed), mechanisms, and pattern of clinical manifestations. Management may include selection of alternative, non-cross reactive agents, drug allergy testing, graded challenge and/or desensitization. Immediate skin testing only identifies risk for immediate-type allergic DHR and has a negative predictive value for only a limited number of drugs (eg, penicillin). Desensitization induces a temporary state of tolerance that is maintained only so long as the drug is continued. This article discusses special considerations about antibiotics, angiotensin-converting enzyme inhibitors, anesthetic agents, aspirin and nonsteroidal antiinflammatory drugs, radiocontrast media, and chemotherapeutic agents.
Topics: Anesthetics; Angiotensin-Converting Enzyme Inhibitors; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Desensitization, Immunologic; Drug Hypersensitivity; Humans; Predictive Value of Tests; Skin Tests
PubMed: 31757230
DOI: 10.1016/j.mcna.2019.09.003 -
Pediatric Allergy and Immunology :... Dec 2018This review highlights research advances and important achievements in food allergy, anaphylaxis, and drug allergy that were published in the Journals of the European... (Review)
Review
This review highlights research advances and important achievements in food allergy, anaphylaxis, and drug allergy that were published in the Journals of the European Academy of Allergy and Clinical Immunology (EAACI) in 2017. Food allergy and anaphylaxis research have continued to rapidly accelerate, with increasing numbers of outstanding developments in 2017. We saw new studies on the mechanisms, diagnosis, prevention of food allergy, and novel food allergens. Drug hypersensitivity, as well as hereditary angioedema, has been highlighted in the present review as the focus of recent developments. The EAACI owns three journals: Allergy, Pediatric Allergy and Immunology (PAI), and Clinical and Translational Allergy (CTA). One of the major goals of the EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2017 in anaphylaxis, and food and drug allergy.
Topics: Academies and Institutes; Anaphylaxis; Drug Hypersensitivity; Food Hypersensitivity; Humans
PubMed: 30276869
DOI: 10.1111/pai.12986 -
The Journal of Allergy and Clinical... Feb 2023
Review
Topics: Humans; Drug Hypersensitivity; Nocebo Effect; Patient Reported Outcome Measures; Placebo Effect
PubMed: 36521832
DOI: 10.1016/j.jaip.2022.11.033 -
The Journal of Allergy and Clinical... May 2024Risk stratification in drug allergy implies that specific risk categories (eg, low, moderate, and high) classify historical drug hypersensitivity reactions. These risk... (Review)
Review
Risk stratification in drug allergy implies that specific risk categories (eg, low, moderate, and high) classify historical drug hypersensitivity reactions. These risk categories can be based on reaction phenotypic characteristics, the timing of the reaction and evaluation, the required reaction management, and individual characteristics. Although a multitude of frameworks have been described in the literature, particularly for penicillin allergy labels, there has yet to be a global consensus, and approaches continue to vary between allergy centers. Immune-mediated drug allergies can sometimes be confirmed using skin testing, but a negative drug challenge is required to demonstrate tolerance and remove the allergy from the electronic health record ("delabel" the allergy). Even for quintessential IgE-mediated drug allergy, penicillin allergy, recent data reveal that a direct oral challenge, without prior skin testing, is an appropriate diagnostic strategy in those who are considered low-risk. Drug allergy pathogenesis and clinical manifestations may vary depending on the culprit drug, and as such, the optimal approach should be based on risk stratification that considers individual patient and reaction characteristics, the likely hypersensitivity reaction phenotype, the drug class, and the patient's clinical needs. This article will describe low-risk drug allergy labels, focusing on β-lactam and sulfonamide antibiotics, nonsteroidal anti-inflammatory drugs, iodinated contrast media, and common chemotherapeutics. This review will also address practical management approaches using currently available risk stratification and clinical decision tools.
Topics: Humans; Drug Hypersensitivity; Skin Tests; Risk Assessment; Penicillins; Immunoglobulin E; Anti-Bacterial Agents
PubMed: 38724164
DOI: 10.1016/j.jaip.2024.03.021 -
Immunology and Allergy Clinics of North... Nov 2017Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical... (Review)
Review
Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical records and clinical history are fundamental. There are a few in vitro tests available in clinical practice, such as serum-specific IgE and basophil activation test. Skin tests are often useful for the diagnosis, although drug challenge is indicated in patients with inconclusive clinical history or to provide safe alternatives. Treatment of anaphylaxis is standard and intramuscular epinephrine is the main agent to prevent morbidity and mortality. Rapid desensitization may be indicated in selected cases.
Topics: Anaphylaxis; Anti-Inflammatory Agents, Non-Steroidal; Diagnosis, Differential; Drug Hypersensitivity; Epinephrine; Humans; Immunoglobulin E; Mastocytosis, Systemic; Practice Guidelines as Topic; Prevalence
PubMed: 28965631
DOI: 10.1016/j.iac.2017.06.002 -
Current Opinion in Allergy and Clinical... Aug 2024To understand the current global scale of drug hypersensitivity (DH) and drug allergy (DA), and to identify possible strategies to increase the accuracy of... (Review)
Review
PURPOSE OF REVIEW
To understand the current global scale of drug hypersensitivity (DH) and drug allergy (DA), and to identify possible strategies to increase the accuracy of epidemiological data.
RECENT FINDINGS
Global patterns of DH/DA seem to be changing and increasing worldwide, but there are still great challenges in capturing quality DH/DA mortality and morbidity statistics (MMS). DH/DA MMS may gain new perspectives with the global implementation of the International Classification of Diseases (ICD)-11. Improving the quality of epidemiological data related to DH/DA should clarify areas of uncertainty, which would lead to better strategies to reduce the burden of these conditions.
SUMMARY
DH/DA remains a complex and unaddressed problem globally that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. DH/DA labels should contribute to people well being, by protecting true allergic individuals from being re-exposed to their allergic drugs and providing needed medications to individuals wrongly labeled as allergic or who have lost allergic sensitivity. The true rate of DH/DA is in fact unknown due to a number of factors, such as misdiagnosis, miscoding and under- and over-notification, among others. Moreover, there is lack of data about DH/DA epidemiology in many countries. Difficulties on collecting accurate and comparable data should be acknowledged, with great impact in the correct labeling DH/DA in electronic health records and official statistics. More accurate definitions, classification and coding may contribute to a better-quality MMS thanks to the ICD-11, under implementation worldwide. Improving the quality of epidemiological data related to DH/DA should clarify areas of uncertainty, which would lead to better strategies to reduce the burden of these conditions. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to DH/DA in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.
Topics: Humans; Drug Hypersensitivity; International Classification of Diseases
PubMed: 38873859
DOI: 10.1097/ACI.0000000000001003