Drug hypersensitivity reactions in Asia: regional issues and challenges

Bernard Yu-Hor Thong; Michaela Lucas; Hye-Ryun Kang; Yoon-Seok Chang; Philip Hei Li; Min Moon Tang; James Yun; Jie Shen Fok; Byung-Keun Kim; Mizuho Nagao; Iris Rengganis; Yi-Giien Tsai; Wen-Hung Chung; Masao Yamaguchi; Ticha Rerkpattanapipat; Wasu Kamchaisatian; Ting Fan Leung; Ho Joo Yoon; Luo Zhang; Amir Hamzah Abdul Latiff; Takao Fujisawa; Francis Thien; Mariana C. Castells; Pascal Demoly; Jiu-Yao Wang; Ruby Pawankar

doi:10.5415/apallergy.2020.10.e8

Journal List > Asia Pac Allergy > v.10(1) > 1148390

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Thong, Lucas, Kang, Chang, Li, Tang, Yun, Fok, Kim, Nagao, Rengganis, Tsai, Chung, Yamaguchi, Rerkpattanapipat, Kamchaisatian, Leung, Yoon, Zhang, Latiff, Fujisawa, Thien, Castells, Demoly, Wang, and Pawankar: Drug hypersensitivity reactions in Asia: regional issues and challenges

Current Review

Asia Pac Allergy 2020;10(1):e8.

Published online: 4 January 2020

DOI: https://doi.org/10.5415/apallergy.2020.10.e8

Drug hypersensitivity reactions in Asia: regional issues and challenges

Bernard Yu-Hor Thong^1,^*, Michaela Lucas², Hye-Ryun Kang³, Yoon-Seok Chang⁴, Philip Hei Li⁵, Min Moon Tang⁶, James Yun⁷, Jie Shen Fok⁸, Byung-Keun Kim⁹, Mizuho Nagao¹⁰, Iris Rengganis¹¹, Yi-Giien Tsai¹², Wen-Hung Chung¹³, Masao Yamaguchi¹⁴, Ticha Rerkpattanapipat¹⁵, Wasu Kamchaisatian¹⁶, Ting Fan Leung¹⁷, Ho Joo Yoon¹⁸, Luo Zhang¹⁹, Amir Hamzah Abdul Latiff²⁰, Takao Fujisawa²¹, Francis Thien²², Mariana C. Castells²³, Pascal Demoly²⁴, Jiu-Yao Wang²⁵, Ruby Pawankar²⁶

¹Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

²Department of Immunology, Pathwest and Sir Charles Gairdner Hospital, Medical School, University of Western Australia, Perth, Australia

³Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Department of Internal Medicine, Seoul National University College of Medicine, Drug Safety Center, Seoul National University Hospital, Seoul, Korea

⁴Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

⁵Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong

⁶Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

⁷Faculty of Medicine and Health, The University of Sydney, Division of Medicine, Nepean Hospital, Sydney, Australia

⁸Department of Respiratory Medicine, Box Hill Hospital, Eastern Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia

⁹Department of Internal Medicine, Korea University Medical Center Anam Hospital, Seoul, Korea

¹⁰Allergy Center of Mie National Hospital, Tsu, Japan

¹¹Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia

¹²School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

¹³Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung and Linkou Branches, College of Medicine, Chang Gung University, Taipei, Taiwan

¹⁴Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan

¹⁵Allergy, Immunology and Rheumatology Division, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

¹⁶Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand

¹⁷Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong

¹⁸Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea

¹⁹Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China

²⁰Allergy & Immunology Centre, Pantai Hospital, Kuala Lumpur, Malaysia

²¹Allergy Center of Mie National Hospital, Tsu, Japan

²²Eastern Health, Melbourne; Monash University, Melbourne, Australia

²³Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA

²⁴Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, UPMC Univ Paris 06, UMRS 1136, Equipe – EPAR – IPLESP, Sorbonne Universités, Paris, France

²⁵Graduate Institute of Medical Sciences, China Medical University, Taichung, Taiwan

²⁶Department of Pediatrics, Nippon Medical School, Tokyo, Japan

^*Correspondence to Bernard Yu-Hor Thong Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. Tel: +65-63577822 Fax: +65-63572686 E-mail: bernard_thong@ttsh.com.sg

Received 27 January 2020 Accepted 27 January 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are geographical, regional, and ethnic differences in the phenotypes and endotypes of patients with drug hypersensitivity reactions (DHRs) in different parts of the world. In Asia, aspects of drug hypersensitivity of regional importance include IgE-mediated allergies and T-cell-mediated reactions, including severe cutaneous adverse reactions (SCARs), to beta-lactam antibiotics, antituberculous drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) and radiocontrast agents. Delabeling of low-risk penicillin allergy using direct oral provocation tests without skin tests have been found to be useful where the drug plausibility of the index reaction is low. Genetic risk associations of relevance to Asia include human leucocyte antigen (HLA)-B*1502 with carbamazepine SCAR, and HLA-B*5801 with allopurinol SCAR in some Asian ethnic groups. There remains a lack of safe and accurate diagnostic tests for antituberculous drug allergy, other than relatively high-risk desensitization regimes to first-line antituberculous therapy. NSAID hypersensitivity is common among both adults and children in Asia, with regional differences in phenotype especially among adults. Low dose aspirin desensitization is an important therapeutic modality in individuals with cross-reactive NSAID hypersensitivity and coronary artery disease following percutaneous coronary intervention. Skin testing allows patients with radiocontrast media hypersensitivity to confirm the suspected agent and test for alternatives, especially when contrasted scans are needed for future monitoring of disease relapse or progression, especially cancers.

Keywords: Anaphylaxis, Asthma, Drugs, Hypersensitivity, Pharmacogenetics

References

1. Mayorga C, Fernandez TD, Montañez MI, Moreno E, Torres MJ. Recent developments and highlights in drug hypersensitivity. Allergy. 2019; 74:2368–81.

2. Kulhas Celik I, Dibek Misirlioglu E, Kocabas CN. Recent developments in drug hypersensitivity in children. Expert Rev Clin Immunol. 2019; 15:723–33.

3. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004; 113:832–6.

4. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, Khan DA, Lang DM, Park HS, Pichler W, Sanchez-Borges M, Shiohara T, Thong BY. International Consensus on drug allergy. Allergy. 2014; 69:420–37.

5. Pichler WJ. Immune pathomechanism and classification of drug hypersensitivity. Allergy. 2019; 74:1457–71.

6. Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ. Antibiotic allergy. Lancet. 2019; 393:183–98.

7. Thong BY. Nonsteroidal anti-inflammatory drug hypersensitivity in the Asia-Pacific. Asia Pac Allergy. 2018; 8:e38.

8. Wang YH, Chen CB, Tassaneeyakul W, Saito Y, Aihara M, Choon SE, Lee HY, Chang MM, Roa FD, Wu CW, Zhang J, Nakkam N, Konyoung P, Okamoto-Uchida Y, Cheung CM, Huang JW, Ji C, Cheng B, Hui RC, Chu CY, Chen YJ, Wu CY, Hsu CK, Chiu TM, Huang YH, Lu CW, Yang CY, Lin YT, Chi MH, Ho HC, Lin JY, Yang CH, Chang YC, Su SC, Wang CW, Fan WL, Hung SI, Chung WH. Asian Severe Cutaneous Adverse Reaction Consortium. The Medication Risk of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Asians: The Major Drug Causality and Comparison With the US FDA Label. Clin Pharmacol Ther. 2019; 105:112–20.

9. Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and management of penicillin allergy: a review. JAMA. 2019; 321:188–99.

10. Norton AE, Konvinse K, Phillips EJ, Broyles AD. Antibiotic allergy in paediatrics. Pediatrics. 2018; 141:pii: e20172497.

11. Zagursky RJ, Pichichero ME. Cross-reactivity in β-lactam allergy. J Allergy Clin Immunol Pract. 2018; 6:72–81.

12. Lucas M, Arnold A, Sommerfield A, Trevenen M, Braconnier L, Schilling A, Abass F, Slevin L, Knezevic B, Blyth C, Murray K, von Ungern-Sternberg B, Rueter K. Antibiotic allergy labels in children are associated with adverse clinical outcomes. J Allergy Clin Immunol Pract. 2019; 7:975–82.

13. Siew LQC, Li PH, Watts TJ, Thomas I, Ue KL, Caballero MR, Rutkowski K, Till SJ, Pillai P, Haque R. Identifying low-risk beta-lactam allergy patients in a UK tertiary centre. J Allergy Clin Immunol Pract. 2019; 7:2173–81.

14. Bourke J, Pavlos R, James I, Phillips E. Improving the effectiveness of penicillin allergy delabeling. J Allergy Clin Immunol Pract. 2015; 3:365–34.

15. Trubiano JA, Beekmann SE, Worth LJ, Polgreen PM, Thursky KA, Slavin MA, Grayson ML, Phillips EJ. Improving antimicrobial stewardship by antibiotic allergy delabeling: evaluation of knowledge, attitude, and practices throughout the emerging infections network. Open Forum Infect Dis. 2016; 3:ofw153.

16. Trubiano JA, Slavin MA, Thursky KA, Grayson ML, Phillips EJ. Beta-lactam and sulfonamide allergy testing should be a standard of care in immunocompromised hosts. J Allergy Clin Immunol Pract. 2019; 7:2151–3.

17. Trubiano JA, Grayson ML, Phillips EJ, Stewardson AJ, Thursky KA, Slavin MA. Antibiotic allergy testing improves antibiotic appropriateness in patients with cancer. J Antimicrob Chemother. 2018; 73:3209–11.

18. Devchand M, Kirkpatrick CMJ, Stevenson W, Garrett K, Perera D, Khumra S, Urbancic K, Grayson ML, Trubiano JA. Evaluation of a pharmacist-led penicillin allergy de-labelling ward round: a novel antimicrobial stewardship intervention. J Antimicrob Chemother. 2019; 74:1725–30.

19. Stevenson B, Trevenen M, Klinken E, Smith W, Yuson C, Katelaris C, Perram F, Burton P, Yun J, Cai F, Barnes S, Spriggs K, Ojaimi S, Mullins R, Salman S, Martinez P, Murray K, Lucas M. Multicenter Australian Study to determine criteria for low- and high-risk penicillin testing in outpatients. J Allergy Clin Immunol Pract. 2019 Oct 08. pii: S2213-2198(19)30851-7. [Epub].DOI: doi: 10.1016/j.jaip.2019.09.025.

20. Li J, Shahabi-Sirjani A, Figtree M, Hoyle P, Fernando SL. Safety of direct drug provocation testing in adults with penicillin allergy and association with health and economic benefits. Ann Allergy Asthma Immunol. 2019; 123:468–75.

21. Arnold A, Sommerfield A, Ramgolam A, Rueter K, Muthusamy S, Noble V, von Ungern-Sternberg BS, Lucas M. The role of skin testing and extended antibiotic courses in assessment of children with penicillin allergy: an Australian experience. J Paediatr Child Health. 2019; 55:428–32.

22. Ardern-Jones MR, Mockenhaupt M. Making a diagnosis in severe cutaneous drug hypersensitivity reactions. Curr Opin Allergy Clin Immunol. 2019; 19:283–93.

23. Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol. 1993; 129:92–6.

24. Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T. Current perspectives on erythema multiforme. Clin Rev Allergy Immunol. 2018; 54:177–84.

25. Yang SC, Hu S, Zhang SZ, Huang JW, Zhang J, Ji C, Cheng B. The epidemiology of Stevens-Johnson syndrome and toxic epidermal necrolysis in China. J Immunol Res. 2018; 2018:4320195.

26. Li LF, Ma C. Epidemiological study of severe cutaneous adverse drug reactions in a city district of China. Clin Exp Dermatol. 2006; 31:642–7.

27. Kang MG, Sohn KH, Kang DY, Park HK, Yang MS, Lee JY, Kang HR. Analysis of individual case safety reports of severe cutaneous adverse reactions in Korea. Yonsei Med J. 2019; 60:208–15.

28. Nguyen KD, Tran TN, Nguyen MT, Nguyen HA, Nguyen HA Jr, Vu DH, Nguyen VD, Bagheri H. Drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in vietnamese spontaneous adverse drug reaction database: a subgroup approach to disproportionality analysis. J Clin Pharm Ther. 2019; 44:69–77.

29. Choon SE, Lai NM. An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia. Indian J Dermatol Venereol Leprol. 2012; 78:734–9.

30. Tee SH, Ng TG. A 5-year retrospective study on clinical patterns and treatment outcome of severe cutaneous adverse drug reactions in Hospital Tengku Ampuan Rahimah, Klang, Malaysia. Malaysian J Dermatol. 2014; 33:9–16.

31. Loo CH, Tan WC, Khor YH, Chan LC. A 10-years retrospective study on Severe Cutaneous Adverse Reactions (SCARs) in a tertiary hospital in Penang, Malaysia. Med J Malaysia. 2018; 73:73–7.

32. Ramalingam R. Severe cutaneous adverse reactions: a 5-year experience in a tertiary referral hospital in Malaysia. Malaysian J Dermatol. 2018; 41:28–34.

33. Su P, Aw CW. Severe cutaneous adverse reactions in a local hospital setting: a 5-year retrospective study. Int J Dermatol. 2014; 53:1339–45.

34. Tan SK, Tay YK. Profile and pattern of Stevens-Johnson syndrome and toxic epidermal necrolysis in a general hospital in Singapore: treatment outcomes. Acta Derm Venereol. 2012; 92:62–6.

35. Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol. 2003; 90:342–7.

36. Suwarsa O, Yuwita W, Dharmadji HP, Sutedja E. Stevens-Johnson syndrome and toxic epidermal necrolysis in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2009-2013. Asia Pac Allergy. 2016; 6:43–7.

37. Saha A, Das NK, Hazra A, Gharami RC, Chowdhury SN, Datta PK. Cutaneous adverse drug reaction profile in a tertiary care outpatient setting in eastern India. Indian J Pharmacol. 2012; 44:792–7.

38. Chung WH, Hung SI, Hong HS, Hsih MS, Yang LC, Ho HC, Wu JY, Chen YT. Medical genetics: a marker for Stevens-Johnson syndrome. Nature. 2004; 428:486.

39. Hung SI, Chung WH, Liou LB, Chu CC, Lin M, Huang HP, Lin YL, Lan JL, Yang LC, Hong HS, Chen MJ, Lai PC, Wu MS, Chu CY, Wang KH, Chen CH, Fann CS, Wu JY, Chen YT. HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U S A. 2005; 102:4134–9.

40. Mallal S, Phillips E, Carosi G, Molina JM, Workman C, Tomazic J, Jagel-Guedes E, Rugina S, Kozyrev O, Cid JF, Hay P, Nolan D, Hughes S, Hughes A, Ryan S, Fitch N, Thororn D, Benbow A. PREDICT-1 Study Team. HLA-B*5701 screening for hypersensitivity to abacavir. N Engl J Med. 2008; 358:568–79. 41. Chen P, Lin JJ, Lu CS, Ong CT, Hsieh PF, Yang CC, Tai CT, Wu SL, Lu CH, Hsu YC, Yu HY, Ro LS, Lu CT, Chu CC, Tsai JJ, Su YH, Lan SH, Sung SF, Lin SY, Chuang HP, Huang LC, Chen YJ, Tsai PJ, Liao HT, Lin YH, Chen CH, Chung WH, Hung SI, Wu JY, Chang CF, Chen L, Chen YT, Shen CY; Taiwan SJS Consortium. Carbamazepine-induced toxic effects and HLA-B*1502 screening in Taiwan. N Engl J Med. 2011; 364:1126–33. 42. Ng CY, Yeh YT, Wang CW, Hung SI, Yang CH, Chang YC, Chang WC, Lin YJ, Chang CJ, Su SC, Fan WL, Chen DY, Wu YJ, Tian YC, Hui RC, Chung WH; Taiwan Severe Cutaneous Adverse Reaction Consortium. Impact of the HLA-B(*)58:01 allele and renal impairment on allopurinol-induced cutaneous adverse reactions. J Invest Dermatol. 2016; 136:1373–81. 43. Chiu ML, Hu M, Ng MH, Yeung CK, Chan JC, Chang MM, Cheng SH, Li L, Tomlinson B. Association between HLA-B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong. Br J Dermatol. 2012; 167:44–9. 44. Cheung YK, Cheng SH, Chan EJ, Lo SV, Ng MH, Kwan P. HLA-B alleles associated with severe cutaneous reactions to antiepileptic drugs in Han Chinese. Epilepsia. 2013; 54:1307–14. 45. Chong KW, Chan DW, Cheung YB, Ching LK, Hie SL, Thomas T, Ling S, Tan EC. Association of carbamazepine-induced severe cutaneous drug reactions and HLA-B*1502 allele status, and dose and treatment duration in paediatric neurology patients in Singapore. Arch Dis Child. 2014; 99:581–4. 46. Nguyen DV, Chu HC, Nguyen DV, Phan MH, Craig T, Baumgart K, van Nunen S. HLA-B*1502 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese. Asia Pac Allergy. 2015; 5:68–77. 47. Mehta TY, Prajapati LM, Mittal B, Joshi CG, Sheth JJ, Patel DB, Dave DM, Goyal RK. Association of HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome among Indians. Indian J Dermatol Venereol Leprol. 2009; 75:579–82. 48. Chang CC, Too CL, Murad S, Hussein S. Association of HLA-B*1502 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens-Johnson syndrome in the multi-ethnic Malaysian population. Int J Dermatol. 2011; 50:221–4. 49. Then SM, Rani ZZ, Raymond AA, Ratnaningrum S, Jamal R. Frequency of the HLA-B*1502 allele contributing to carbamazepine-induced hypersensitivity reactions in a cohort of Malaysian epilepsy patients. Asian Pac J Allergy Immunol. 2011; 29:290–3. 50. Mushiroda T, Takahashi Y, Onuma T, Yamamoto Y, Kamei T, Hoshida T, Takeuchi K, Otsuka K, Okazaki M, Watanabe M, Kanemoto K, Oshima T, Watanabe A, Minami S, Saito K, Tanii H, Shimo Y, Hara M, Saitoh S, Kinoshita T, Kato M, Yamada N, Akamatsu N, Fukuchi T, Ishida S, Yasumoto S, Takahashi A, Ozeki T, Furuta T, Saito Y, Izumida N, Kano Y, Shiohara T, Kubo M; GENCAT Study Group. Association of HLA-A*31:01 screening with the incidence of carbamazepine-induced cutaneous adverse reactions in a Japanese population. JAMA Neurol. 2018; 75:842–9. 51. Kim SH, Lee KW, Song WJ, Kim SH, Jee YK, Lee SM, Kang HR, Park HW, Cho SH, Park SH, Min KU, Chang YS; Adverse Drug Reaction Research Group in Korea. Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans. Epilepsy Res. 2011; 97:190–7. 52. Chen WT, Wang CW, Lu CW, Chen CB, Lee HE, Hung SI, Choon SE, Yang CH, Liu MT, Chen TJ, Fan WL, Su SC, Lin YY, Chang YC, Chung WH; Taiwan Severe Cutaneous Adverse Reaction Consortium. The function of HLA-B*13:01 involved in the pathomechanism of dapsone-induced severe cutaneous adverse reactions. J Invest Dermatol. 2018; 138:1546–54. 53. Tempark T, Satapornpong P, Rerknimitr P, Nakkam N, Saksit N, Wattanakrai P, Jantararoungtong T, Koomdee N, Mahakkanukrauh A, Tassaneeyakul W, Suttisai S, Pratoomwun J, Klaewsongkram J, Rerkpattanapipat T, Sukasem C. Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with HLA-B*13: 01 allele in the Thai population. Pharmacogenet Genomics. 2017; 27:429–37.

54. Chen CB, Hsiao YH, Wu T, Hsih MS, Tassaneeyakul W, Jorns TP, Sukasem C, Hsu CN, Su SC, Chang WC, Hui RC, Chu CY, Chen YJ, Wu CY, Hsu CK, Chiu TM, Sun PL, Lee HE, Yang CY, Kao PH, Yang CH, Ho HC, Lin JY, Chang YC, Chen MJ, Lu CW, Ng CY, Kuo KL, Lin CY, Yang CS, Chen DP, Chang PY, Wu TL, Lin YJ, Weng YC, Kuo TT, Hung SI, Chung WH. Taiwan Severe Cutaneous Adverse Reaction Consortium. Risk and association of HLA with oxcarbazepine-induced cutaneous adverse reactions in Asians. Neurology. 2017; 88:78–86.

55. Chang CC, Ng CC, Too CL, Choon SE, Lee CK, Chung WH, Hussein SH, Lim KS, Murad S. Association of HLA-B*15:13 and HLA-B*15:02 with phenytoin-induced severe cutaneous adverse reactions in a Malay population. Pharmacogenomics J. 2017; 17:170–3.

56. Su SC, Chen CB, Chang WC, Wang CW, Fan WL, Lu LY, Nakamura R, Saito Y, Ueta M, Kinoshita S, Sukasem C, Yampayon K, Kijsanayotin P, Nakkam N, Saksit N, Tassaneeyakul W, Aihara M, Lin YJ, Chang CJ, Wu T, Hung SI, Chung WH. HLA alleles and CYP2C9*3 as predictors of phenytoin hypersensitivity in East Asians. Clin Pharmacol Ther. 2019; 105:476–85.

57. Chung WH, Chang WC, Lee YS, Wu YY, Yang CH, Ho HC, Chen MJ, Lin JY, Hui RC, Ho JC, Wu WM, Chen TJ, Wu T, Wu YR, Hsih MS, Tu PH, Chang CN, Hsu CN, Wu TL, Choon SE, Hsu CK, Chen DY, Liu CS, Lin CY, Kaniwa N, Saito Y, Takahashi Y, Nakamura R, Azukizawa H, Shi Y, Wang TH, Chuang SS, Tsai SF, Chang CJ, Chang YS, Hung SI. Taiwan Severe Cutaneous Adverse Reaction Consortium; Japan Pharmacogenomics Data Science Consortium. Genetic variants associated with phenytoin-related severe cutaneous adverse reactions. JAMA. 2014; 312:525–34.

58. Manuyakorn W, Siripool K, Kamchaisatian W, Pakakasama S, Visudtibhan A, Vilaiyuk S, Rujirawat T, Benjaponpitak S. Phenobarbital-induced severe cutaneous adverse drug reactions are associated with CYP2C19*2 in Thai children. Pediatr Allergy Immunol. 2013; 24:299–303.

59. Toh DS, Tan LL, Aw DC, Pang SM, Lim SH, Thirumoorthy T, Lee HY, Tay YK, Tan SK, Vasudevan A, Lateef A, Chong YY, Chan YC, Loke C, Chan CL, Koay ES, Ren EC, Lee EJ, Sung C. Building pharmacogenetics into a pharmacovigilance program in Singapore: using serious skin rash as a pilot study. Pharmacogenomics J. 2014; 14:316–21.

60. Alfirevic A, Pirmohamed M, Marinovic B, Harcourt-Smith L, Jorgensen AL, Cooper TE. Genetic testing for prevention of severe drug-induced skin rash. Cochrane Database Syst Rev. 2019; 7:CD010891.

61. Shiohara T, Mizukawa Y. Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): an update in 2019. Allergol Int. 2019; 68:301–8.

62. Kano Y, Tohyama M, Aihara M, Matsukura S, Watanabe H, Sueki H, Iijima M, Morita E, Niihara H, Asada H, Kabashima K, Azukizawa H, Hashizume H, Nagao K, Takahashi H, Abe R, Sotozono C, Kurosawa M, Aoyama Y, Chu CY, Chung WH, Shiohara T. Sequelae in 145 patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms: survey conducted by the Asian Research Committee on Severe Cutaneous Adverse Reactions (ASCAR). J Dermatol. 2015; 42:276–82.

63. Dheda K, Barry CE 3rd, Maartens G. Tuberculosis. Lancet. 2016; 387:1211–26.

64. Nagarajan S, Whitaker P. Management of adverse reactions to first-line tuberculosis antibiotics. Curr Opin Allergy Clin Immunol. 2018; 18:333–41. erculosis. Lancet. 2016; 387:1211–26.

65. Mayorga C, Doña I, Perez-Inestrosa E, Fernández TD, Torres MJ. The value of in vitro tests to diminish drug challenges. Int J Mol Sci. 2017; 18.

66. Ingen-Housz-Oro S, Assier H, Gener G, Milpied B, Soria A, Bernier C, Descamps V, Tetart F, Staumont-Sallé D, Valeyrie-Allanore L, Valois A, Sassolas B, Bensaid B, Lebrun-Vignes B, Barbaud A. Groupe FISARD de la SFD. Delayed hypersensitivity to antituberculosis drugs. Proposed practical management plan for exanthema: when to stop, which allergological investigations to perform, and how to restart treatment. Ann Dermatol Venereol. 2019; 146:313–8.

67. Scherer K, Brockow K, Aberer W, Gooi JH, Demoly P, Romano A, Schnyder B, Whitaker P, Cernadas JS, Bircher AJ. ENDA, the European Network on Drug Allergy and the EAACI Drug Allergy Interest Group. Desensitization in delayed drug hypersensitivity reactions – an EAACI position paper of the Drug Allergy Interest Group. Allergy. 2013; 68:844–52.

68. Cernadas JR, Brockow K, Romano A, Aberer W, Torres MJ, Bircher A, Campi P, Sanz ML, Castells M, Demoly P, Pichler WJ. European Network of Drug Allergy and the EAACI interest group on drug hypersensitivity. General considerations on rapid desensitization for drug hypersensitivity – a consensus statement. Allergy. 2010; 65:1357–66.

69. Rerkpattanapipat T, Chiriac AM, Demoly P. Drug provocation tests in hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol. 2011; 11:299–304.

70. Zha BS, Nahid P. Treatment of drug-susceptible tuberculosis. Clin Chest Med. 2019; 40:763–74.

71. Ban GY, Jeong YJ, Lee SH, Shin SS, Shin YS, Park HS, Kim SH, Ye YM. Efficacy and tolerability of desensitization in the treatment of delayed drug hypersensitivities to antituberculosis medications. Respir Med. 2019; 147:44–50.

72. Siripassorn K, Ruxrungtham K, Manosuthi W. Successful drug desensitization in patients with delayed-type allergic reactions to antituberculosis drugs. Int J Infect Dis. 2018; 68:61–8.

73. Thong BY, Chia FL, Tan SC, Tan TC, Leong KP, Tan JW, Tang CY, Hou JF, Chan GY, Chng HH. A retrospective study on sequential desensitization-rechallenge for antituberculosis drug allergy. Asia Pac Allergy. 2014; 4:156–63.

74. Kowalski ML, Makowska JS, Blanca M, Bavbek S, Bochenek G, Bousquet J, Bousquet P, Celik G, Demoly P, Gomes ER, Niż ankowska-Mogilnicka E, Romano A, Sanchez-Borges M, Sanz M, Torres MJ, De Weck A, Szczeklik A, Brockow K. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) – classification, diagnosis and management: review of the EAACI/ENDA(#) and GA2LEN/HANNA*. Allergy. 2011; 66:818–29.

75. Kowalski ML, Asero R, Bavbek S, Blanca M, Blanca-Lopez N, Bochenek G, Brockow K, Campo P, Celik G, Cernadas J, Cortellini G, Gomes E, Niżankowska-Mogilnicka E, Romano A, Szczeklik A, Testi S, Torres MJ, Wöhrl S, Makowska J. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy. 2013; 68:1219–32.

76. Kidon M, Blanca-Lopez N, Gomes E, Terreehorst I, Tanno L, Ponvert C, Chin CW, Caubet JC, Soyer O, Mori F, Blanca M, Atanaskovic-Markovic M. EAACI/ENDA Position Paper: Diagnosis and management of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) in children and adolescents. Pediatr Allergy Immunol. 2018; 29:469–80.

77. Lu Y, Li S, Song L, Jin H, Li Y, Zhong N, Zhang X. Low prevalence of hypersensitivity to nonsteroidal anti-inflammatory drugs in Chinese patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2014; 271:2711–5.

78. Fan Y, Chen S, Qu X, Zuo K, Li X, Huang J, Xu G, Mi J, Li H. A lower prevalence of asthma among patients with chronic rhinosinusitis in southern China. J Allergy Clin Immunol. 2011; 127:520–2.

79. Moon JY, Kim SH, Kim TB, Kim SH, Chang YS, Lee JH, Cho YS, Park JW, Jang AS, Park CS, Nahm DH, Cho YJ, Cho SH, Choi BW, Moon HB, Yoon HJ. COREA study group. Aspirin-intolerant asthma in the Korean population: prevalence and characteristics based on a questionnaire survey. Respir Med. 2013; 107:202–8.

80. Lee HY, Ye YM, Kim SH, Ban GY, Kim SC, Kim JH, Shin YS, Park HS. Identification of phenotypic clusters of nonsteroidal anti-inflammatory drugs exacerbated respiratory disease. Allergy. 2017; 72:616–26.

81. Tay TR, Choo XN, Yii A, Chung KF, Chan YH, Wong HS, Chan A, Tee A, Koh MS. Asthma phenotypes in a multi-ethnic Asian cohort. Respir Med. 2019; 157:42–8.

82. Llanora GV, Loo EX, Gerez IF, Cheng YK, Shek LP. Etoricoxib: a safe alternative for NSAID intolerance in Asian patients. Asian Pac J Allergy Immunol. 2013; 31:330–3.

83. Bakhtiar MF, Too CL, Tang MM, Tan LK, Sulaiman S, Fauzi NAA, Nagum AR, Rayappa GC. Non-steroidal anti-inflammatory drugs (NSAIDs) hypersensitivity phenotypes and their common triggering medications. Clin Transl Allergy. 2018; 8(Suppl 3):P130.

84. Kidon MI, Kang LW, Chin CW, Hoon LS, See Y, Goh A, Lin JT, Chay OM. Early presentation with angioedema and urticaria in cross-reactive hypersensitivity to nonsteroidal antiinflammatory drugs among young, Asian, atopic children. Pediatrics. 2005; 116:e675–80.

85. Kidon MI, Liew WK, Chiang WC, Lim SH, Goh A, Tang JP, Chay OM. Hypersensitivity to paracetamol in Asian children with early onset of nonsteroidal anti-inflammatory drug allergy. Int Arch Allergy Immunol. 2007; 144:51–6.

86. Loh W, Lim HH, Rao R, Goh A, Ong LX, Chiang WC. Tolerance to etoricoxib in children with nonsteroidal anti-inflammatory drug hypersensitivity. Asia Pac Allergy. 2015; 5:40–6.

87. Pham DL, Kim JH, Trinh TH, Park HS. What we know about nonsteroidal anti-inflammatory drug hypersensitivity. Korean J Intern Med. 2016; 31:417–32.

88. Bakhtiar MF, Too CL, Tang MM, Tan LK, Sulaiman S, Fauzi NAA, Nagum AR, Rayappa GC. HLA-A*11:01 and A*24:02 are risk factors for Malay patients with urticaria/angioedema induced by non-steroidal anti-inflammatory drugs. Clin Transl Allergy. 2018; 8(Suppl 3):P93.

89. Cortellini G, Romano A, Santucci A, Barbaud A, Bavbek S, Bignardi D, Blanca M, Bonadonna P, Costantino MT, Laguna JJ, Lombardo C, Losappio LM, Makowska J, Nakonechna A, Quercia O, Pastorello EA, Patella V, Terreehorst I, Testi S, Cernadas JR. EAACI Drug Interest Group on Challenge and Desensitization Procedures with Aspirin in CAD, Dionicio Elera J, Lippolis D, Voltolini S, Grosseto D. Clinical approach on challenge and desensitization procedures with aspirin in patients with ischemic heart disease and nonsteroidal anti-inflammatory drug hypersensitivity. Allergy. 2017; 72:498–506.

90. Lee JK, Tsui KL, Cheung CY, Chau CH, Chan HL, Wu KL, Cheung GS, Choi MC, Chan KK, Li SK. Aspirin desensitisation for Chinese patients with coronary artery disease. Hong Kong Med J. 2013; 19:207–13.

91. Brockow K. Diagnosis and treatment of radiocontrast media hypersensitivity. Allergy. 2019 Dec 11. [Epub]. DOI: doi: 10.1111/all.14147.

92. Sánchez-Borges M, Aberer W, Brockow K, Celik GE, Cernadas J, Greenberger PA, Masse MS, Schrijvers R, Trautmann A. Controversies in drug allergy: radiographic contrast media. J Allergy Clin Immunol Pract. 2019; 7:61–5.

93. Lee SY, Kang DY, Kim JY, Yoon SH, Choi YH, Lee W, Cho SH, Kang HR. Incidence and risk factors of immediate hypersensitivity reactions associated with low-osmolar iodinated contrast media: a longitudinal study based on a real-time monitoring system. J Investig Allergol Clin Immunol. 2019; 29:444–50.

95. Cha MJ, Kang DY, Lee W, Yoon SH, Choi YH, Byun JS, Lee J, Kim YH, Choo KS, Cho BS, Jeon KN, Jung JW, Kang HR. Hypersensitivity reactions to iodinated contrast media: a multicenter study of 196 081 patients. Radiology. 2019; 293:117–24.

96. An J, Jung H, Kwon OY, Kang Y, Lee JH, Won HK, Song WJ, Kwon HS, Cho YS, Moon HB, Kim TB. Differences in adverse reactions among iodinated contrast media: analysis of the KAERS database. J Allergy Clin Immunol Pract. 2019; 7:2205–11.

97. Sohn KH, Kim GW, Lee SY, Kim HS, Cho SH, Han JK, Kang HR. Immediate and delayed hypersensitivity after intra-arterial injection of iodinated contrast media: a prospective study in patients with coronary angiography. Eur Radiol. 2019; 29:5314–21.

98. Kwon OY, Lee JH, Park SY, Seo B, Won HK, Kang Y, An J, Kwon HS, Song WJ, Cho YS, Moon HB, Kim TB. Novel strategy for the prevention of recurrent hypersensitivity reactions to radiocontrast media based on skin testing. J Allergy Clin Immunol Pract. 2019; 7:2707–13.

99. Trautmann A, Brockow K, Behle V, Stoevesandt J. Radiocontrast media hypersensitivity: skin testing differentiates allergy from nonallergic reactions and identifies a safe alternative as proven by intravenous provocation. J Allergy Clin Immunol Pract. 2019; 7:2218–24.

100. Abe S, Fukuda H, Tobe K, Ibukuro K. Protective effect against repeat adverse reactions to iodinated contrast medium: Premedication vs. changing the contrast medium. Eur Radiol. 2016; 26:2148–54.

101. Park HJ, Park JW, Yang MS, Kim MY, Kim SH, Jang GC, Nam YH, Kim GW, Kim S, Park HK, Jung JW, Park JS, Kang HR. Re-exposure to low osmolar iodinated contrast media in patients with prior moderate-to-severe hypersensitivity reactions: a multicentre retrospective cohort study. Eur Radiol. 2017; 27:2886–93.

102. Park SJ, Kang DY, Sohn KH, Yoon SH, Lee W, Choi YH, Cho SH, Kang HR. Immediate mild reactions to CT with iodinated contrast media: strategy of contrast media readministration without corticosteroids. Radiology. 2018; 288:710–6.

103. Uppal S, DeCicco AE, Intini A, Josephson RA. Rapid desensitization to overcome contrast allergy prior to urgent coronary angiography. Int Heart J. 2018; 59:622–5.

104. Hong SJ, Bloch KJ, Wong JT. Rapid IV challenge/desensitization using iso-osmolar radiocontrast medium (RCM) in two patients at high risk for anaphylactoid reactions. J Allergy Clin Immunol. 2002; 109:S150.

105. Gandhi S, Litt D, Chandy M, Nguyen BM, Jindal NL, Tarlo SM, Overgaard CB. Successful rapid intravenous desensitization for radioiodine contrast allergy in a patient requiring urgent coronary angiography. J Allergy Clin Immunol Pract. 2014; 2:101–2.

106. Behzadi AH, Zhao Y, Farooq Z, Prince MR. Immediate allergic reactions to gadolinium-based contrast agents: a systematic review and meta-analysis. Radiology. 2018; 286:471–82.

107. Thong BY, Mirakian R, Castells M, Pichler WJ, Romano A, Bonadonna P, Deleanu D, Kowalski M, Yanez A, Lleonart R, Sanchez-Borges M, Demoly P. A World Allergy Organization international survey on diagnostic procedures and therapies in drug allergy/hypersensitivity. World Allergy Organ J. 2011; 4:257–70.

Summary Table

Beta-lactam allergy

· Risk stratification of the likelihood of penicillin allergy based on history and non–IgE-mediated type of clinical manifestations of the index adverse drug reaction, form the basis of safe direct oral amoxicillin/penicillin challenge for low-risk patients without the need for skin tests.

· Delabeling and de-escalation encourage appropriate narrow-spectrum antimicrobial use, preventing the

· Delabeling and de-escalation encourage appropriate narrow-spectrum antimicrobial use, preventing the increasing incidence of antimicrobial resistance.

Severe cutaneous adverse reactions

· The most commonly implicated drugs in Asia are antiepileptic drugs (carbamazepine, phenytoin, lamotrigine), allopurinol and antimicrobials.

· Although HLA-B*1502 (carbamazepine), HLA-B*5801 (allopurinol) and HLA-B*5701 (abacavir) testing prior to drug initiation may reduce the risk of severe cutaneous adverse reaction (SCAR), a recent Cochrane review found no eligible evidence on genetic testing for severe drug-induced skin rash in relation to different drugs and classes of drugs.

Antituberculous drug allergy

· Many antituberculous drug hypersensivity reactions are SCARs.

· Desensitization or any re-exposure is of much higher risk. Desensitization protocols involving sequential re-introduction of antituberculous drugs are commonly used given the paucity of well-validated in vitro and in vivo tests to identify the causative drug to restart during induction combination therapy.

Nonsteroidal anti-inflammatory drug hypersensitivity

· The phenotype in children and adolescents tends to have overlapping features, with a much lower prevalence of nonsteroidal anti-inflammatory (NSAID) exacerbated respiratory disease compared to adults.

· Low-dose aspirin desensitization (up to 100 mg/day) for coronary artery disease has been found to be effective and safe in patients with NSAID hypersensitivity.

Radiocontrast media hypersensitivity

· Radiocontrast media (RCM) drug hypersensitivity reactions (DHR) may be allergic or nonallergic, immediate or non-immediate (delayed); nonionic and hyperosmolar agents are associated with higher risks of DHR.

· Skin tests are increasingly useful in the management of patients with RCM DHR, especially those who may require repeat contrasted imaging.

· Negative intradermal tests are used to select alternative RCM to prevent recurrent DHR. International guidelines suggest changing RCM within the same class of low-osmolar RCM.

TOOLS

Similar articles