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Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients

Background: Drug allergies (DA) are immunologically mediated adverse drug reactions and their manifestations depend on a variety of drug- and patient-specific factors. The dysregulated immune system underpinning rheumatological diseases may also lead to an increase in hypersensitivity reactions, inc...

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Autores principales: Chan, Shirley Chiu Wai, Yeung, Winnie Wan Yin, Wong, Jane Chi Yan, Chui, Ernest Sing Hong, Lee, Matthew Shing Him, Chung, Ho Yin, Cheung, Tommy Tsang, Lau, Chak Sing, Li, Philip Hei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695245/
https://www.ncbi.nlm.nih.gov/pubmed/33182278
http://dx.doi.org/10.3390/diagnostics10110918
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author Chan, Shirley Chiu Wai
Yeung, Winnie Wan Yin
Wong, Jane Chi Yan
Chui, Ernest Sing Hong
Lee, Matthew Shing Him
Chung, Ho Yin
Cheung, Tommy Tsang
Lau, Chak Sing
Li, Philip Hei
author_facet Chan, Shirley Chiu Wai
Yeung, Winnie Wan Yin
Wong, Jane Chi Yan
Chui, Ernest Sing Hong
Lee, Matthew Shing Him
Chung, Ho Yin
Cheung, Tommy Tsang
Lau, Chak Sing
Li, Philip Hei
author_sort Chan, Shirley Chiu Wai
collection PubMed
description Background: Drug allergies (DA) are immunologically mediated adverse drug reactions and their manifestations depend on a variety of drug- and patient-specific factors. The dysregulated immune system underpinning rheumatological diseases may also lead to an increase in hypersensitivity reactions, including DA. The higher prevalence of reported DA, especially anti-microbials, also restricts the medication repertoire for these already immunocompromised patients. However, few studies have examined the prevalence and impact of reported DA in this group of patients. Methods: Patients with a diagnosis of rheumatoid arthritis (RA), spondyloarthritis (SpA), or systemic lupus erythematosus (SLE) were recruited from the rheumatology clinics in a tertiary referral hospital between 2018 and 2019. Prevalence and clinical outcomes of reported DA among different rheumatological diseases were calculated and compared to a cohort of hospitalized non-rheumatology patients within the same period. Results: A total of 6081 patients (2541 rheumatology patients: 1286 RA, 759 SpA, and 496 SLE; and 3540 controls) were included. DA was more frequently reported among rheumatology patients compared to controls (23.8% vs. 13.8%, p < 0.01). Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) were the two most commonly reported categories of DA with a prevalence of 12.0% and 5.1%, respectively. Reported antibiotics allergies were more frequent in patients with RA (OR = 1.20, 95% CI = 1.02–1.62, p = 0.03) and SLE (OR = 4.69, 95% CI = 3.69–5.95, p < 0.01); and associated with increased infection-related admissions among rheumatology patients (OR = 1.79, 95% CI = 1.09–2.95, p = 0.02). Among the subgroup of patients referred for allergy testing, 85.7% of beta-lactam antibiotic allergy labels were found to be inaccurate and de-labelled after negative drug provocation testing. Conclusion: The prevalence of reported DA was significantly higher in rheumatology patients. Reported antibiotic allergy was associated with increased rate of infection-related admissions. However, the rate of genuine antibiotic allergy was low. Further studies are needed to guide proper assessment of reported DA and impact of comprehensive allergy testing in this group of patients.
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spelling pubmed-76952452020-11-28 Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients Chan, Shirley Chiu Wai Yeung, Winnie Wan Yin Wong, Jane Chi Yan Chui, Ernest Sing Hong Lee, Matthew Shing Him Chung, Ho Yin Cheung, Tommy Tsang Lau, Chak Sing Li, Philip Hei Diagnostics (Basel) Article Background: Drug allergies (DA) are immunologically mediated adverse drug reactions and their manifestations depend on a variety of drug- and patient-specific factors. The dysregulated immune system underpinning rheumatological diseases may also lead to an increase in hypersensitivity reactions, including DA. The higher prevalence of reported DA, especially anti-microbials, also restricts the medication repertoire for these already immunocompromised patients. However, few studies have examined the prevalence and impact of reported DA in this group of patients. Methods: Patients with a diagnosis of rheumatoid arthritis (RA), spondyloarthritis (SpA), or systemic lupus erythematosus (SLE) were recruited from the rheumatology clinics in a tertiary referral hospital between 2018 and 2019. Prevalence and clinical outcomes of reported DA among different rheumatological diseases were calculated and compared to a cohort of hospitalized non-rheumatology patients within the same period. Results: A total of 6081 patients (2541 rheumatology patients: 1286 RA, 759 SpA, and 496 SLE; and 3540 controls) were included. DA was more frequently reported among rheumatology patients compared to controls (23.8% vs. 13.8%, p < 0.01). Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) were the two most commonly reported categories of DA with a prevalence of 12.0% and 5.1%, respectively. Reported antibiotics allergies were more frequent in patients with RA (OR = 1.20, 95% CI = 1.02–1.62, p = 0.03) and SLE (OR = 4.69, 95% CI = 3.69–5.95, p < 0.01); and associated with increased infection-related admissions among rheumatology patients (OR = 1.79, 95% CI = 1.09–2.95, p = 0.02). Among the subgroup of patients referred for allergy testing, 85.7% of beta-lactam antibiotic allergy labels were found to be inaccurate and de-labelled after negative drug provocation testing. Conclusion: The prevalence of reported DA was significantly higher in rheumatology patients. Reported antibiotic allergy was associated with increased rate of infection-related admissions. However, the rate of genuine antibiotic allergy was low. Further studies are needed to guide proper assessment of reported DA and impact of comprehensive allergy testing in this group of patients. MDPI 2020-11-09 /pmc/articles/PMC7695245/ /pubmed/33182278 http://dx.doi.org/10.3390/diagnostics10110918 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chan, Shirley Chiu Wai
Yeung, Winnie Wan Yin
Wong, Jane Chi Yan
Chui, Ernest Sing Hong
Lee, Matthew Shing Him
Chung, Ho Yin
Cheung, Tommy Tsang
Lau, Chak Sing
Li, Philip Hei
Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title_full Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title_fullStr Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title_full_unstemmed Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title_short Prevalence and Impact of Reported Drug Allergies among Rheumatology Patients
title_sort prevalence and impact of reported drug allergies among rheumatology patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695245/
https://www.ncbi.nlm.nih.gov/pubmed/33182278
http://dx.doi.org/10.3390/diagnostics10110918
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