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Article: Diagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries

TitleDiagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries
Authors
KeywordsAnaphylaxis
Contrast media
Penicillins
Pharmacogenetics
Skin tests
Issue Date2020
PublisherAsia Pacific Association of Allergy, Asthma and Clinical Immunology. The Journal's web site is located at http://www.apallergy.org/
Citation
Asia Pacific Allergy, 2020, v. 10 n. 4, p. article no. e36 How to Cite?
AbstractBackground: The issues and challenges in the diagnosis of drug allergy/hypersensitivity among children and adults in Asia are likely to be different from non-Asian countries. Objective: To study the diagnostic modalities used in the evaluation and management of drug allergy/drug hypersensitivity reactions (DHRs) among member societies of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). Methods: A questionnaire comprising 41 questions was circulated electronically to member societies and individual members of APAAACI between January 23, 2020 and March 6, 2020. Results: Twenty-six respondents from 15 member societies and 1 individual member responded. European DHR guidelines were most commonly used. Skin prick and intradermal testing was used by 100%, with only 60% having access to commercial penicillin skin test reagents. In vitro-specific IgE tests were used by 75%, and basophil activation test by 56.3% for immediate DHR. Patch tests were used by 75% in contrast to lymphocyte transformation tests by 25% for nonimmediate DHR. Drug provocation tests were used by 68.8%, the most common indication being to exclude hypersensitivity where history/symptoms were not suggestive of drug hypersensitivity/allergy (93.3%). Human leukocyte antigen (HLA) genotype testing was mandatory among 25% respondents before new carbamazepine prescriptions, and 8.3% for allopurinol prescriptions. Conclusions: There was increased use of skin testing for iodinated contrast media hypersensitivity and patch testing for nonimmediate DHR. HLA genotype testing prior to new carbamazepine, allopurinol and abacavir prescriptions remain variable despite strong associations for severe cutaneous adverse reactions with Asian ethnicity. Results of this survey form a useful framework for developing educational and training needs and for improving access to drug allergy diagnostic and treatment modalities across APAAACI member societies.
Persistent Identifierhttp://hdl.handle.net/10722/291180
ISSN
2023 Impact Factor: 1.6
2023 SCImago Journal Rankings: 0.516
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTang, MM-
dc.contributor.authorFok, JS-
dc.contributor.authorThong, BYH-
dc.contributor.authorYun, J-
dc.contributor.authorLi, PH-
dc.contributor.authorKang, HR-
dc.contributor.authorThien, F-
dc.contributor.authorYamaguchi, M-
dc.contributor.authorLucas, M-
dc.contributor.authorChang, YS-
dc.contributor.authorKim, BK-
dc.contributor.authorNagao, M-
dc.contributor.authorRengganis, I-
dc.contributor.authorTsai, YG-
dc.contributor.authorChung, WH-
dc.contributor.authorRerkpattanapipat, T-
dc.contributor.authorKamchaisatian, W-
dc.contributor.authorLeung, TF-
dc.contributor.authorHo, JY-
dc.contributor.authorZhang, L-
dc.contributor.authorLatiff, AHA-
dc.contributor.authorFujisawa, T-
dc.contributor.authorCastells, MC-
dc.contributor.authorDemoly, P-
dc.contributor.authorWang, JY-
dc.contributor.authorPawankar, R-
dc.date.accessioned2020-11-07T13:53:21Z-
dc.date.available2020-11-07T13:53:21Z-
dc.date.issued2020-
dc.identifier.citationAsia Pacific Allergy, 2020, v. 10 n. 4, p. article no. e36-
dc.identifier.issn2233-8276-
dc.identifier.urihttp://hdl.handle.net/10722/291180-
dc.description.abstractBackground: The issues and challenges in the diagnosis of drug allergy/hypersensitivity among children and adults in Asia are likely to be different from non-Asian countries. Objective: To study the diagnostic modalities used in the evaluation and management of drug allergy/drug hypersensitivity reactions (DHRs) among member societies of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). Methods: A questionnaire comprising 41 questions was circulated electronically to member societies and individual members of APAAACI between January 23, 2020 and March 6, 2020. Results: Twenty-six respondents from 15 member societies and 1 individual member responded. European DHR guidelines were most commonly used. Skin prick and intradermal testing was used by 100%, with only 60% having access to commercial penicillin skin test reagents. In vitro-specific IgE tests were used by 75%, and basophil activation test by 56.3% for immediate DHR. Patch tests were used by 75% in contrast to lymphocyte transformation tests by 25% for nonimmediate DHR. Drug provocation tests were used by 68.8%, the most common indication being to exclude hypersensitivity where history/symptoms were not suggestive of drug hypersensitivity/allergy (93.3%). Human leukocyte antigen (HLA) genotype testing was mandatory among 25% respondents before new carbamazepine prescriptions, and 8.3% for allopurinol prescriptions. Conclusions: There was increased use of skin testing for iodinated contrast media hypersensitivity and patch testing for nonimmediate DHR. HLA genotype testing prior to new carbamazepine, allopurinol and abacavir prescriptions remain variable despite strong associations for severe cutaneous adverse reactions with Asian ethnicity. Results of this survey form a useful framework for developing educational and training needs and for improving access to drug allergy diagnostic and treatment modalities across APAAACI member societies.-
dc.languageeng-
dc.publisherAsia Pacific Association of Allergy, Asthma and Clinical Immunology. The Journal's web site is located at http://www.apallergy.org/-
dc.relation.ispartofAsia Pacific Allergy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAnaphylaxis-
dc.subjectContrast media-
dc.subjectPenicillins-
dc.subjectPharmacogenetics-
dc.subjectSkin tests-
dc.titleDiagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries-
dc.typeArticle-
dc.identifier.emailLi, PH: liphilip@hku.hk-
dc.identifier.authorityLi, PH=rp02669-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5415/apallergy.2020.10.e36-
dc.identifier.pmid33178561-
dc.identifier.pmcidPMC7610088-
dc.identifier.hkuros318692-
dc.identifier.volume10-
dc.identifier.issue4-
dc.identifier.spagearticle no. e36-
dc.identifier.epagearticle no. e36-
dc.identifier.isiWOS:000585970900002-
dc.publisher.placeKorea, Republic of-
dc.identifier.issnl2233-8276-

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