Diagnostic evaluation of hypersensitivity reactions to arylpropionic acid derivatives: a descriptive observational study focusing on clinical characteristics and potential risk factors in children.
{"title":"Diagnostic evaluation of hypersensitivity reactions to arylpropionic acid derivatives: a descriptive observational study focusing on clinical characteristics and potential risk factors in children.","authors":"Tugba Arikoglu, Nazan Tokmeci, Ali Demirhan, Aylin Kont Ozhan, Aysu İlhan Yalaki, Veysi Akbey, Semanur Kuyucu","doi":"10.1007/s11096-024-01756-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Arylpropionic acid derivatives (APs) are the main triggers of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity. Data on clinical patterns and risk factors for AP hypersensitivity in children are quite limited.</p><p><strong>Aim: </strong>To assess the clinical characteristics and potential risk factors for proven AP hypersensitivity in children.</p><p><strong>Method: </strong>Patients with a history of AP hypersensitivity were retrospectively assessed using a standardized diagnostic algorithm. Children with confirmed hypersensitivity were defined as selective responders or cross-intolerants based on the result of drug provocation tests and further categorized according to the EAACI/ENDA classification. A multivariable logistic regression analysis was performed to analyze the potential risk factors for proven AP hypersensitivity.</p><p><strong>Results: </strong>A total of 166 patients (51.2% male, median age of six years) with a history of AP hypersensitivity were included. Ibuprofen (89.2%) was the most frequently reported AP in the patients' histories. The reported hypersensitivity of 40 (22.4%) patients was confirmed by diagnostic testing: eight (13.6%) patients with a history of reaction only to APs and 32 (29.9%) patients with a history of reactions to multiple NSAIDs, including chemically unrelated NSAIDs in addition to APs. Five (12.5%) patients were classified as selective responders and 35 (87.5%) were cross-intolerants. Overall, five (12.5%) of the confirmed cases could not be categorized according to the EAACI/ENDA classification. Older age (aOR: 1.11, 95% CI 1.02-1.21, p = 0.015), chronic urticaria as an underlying disease (aOR: 2.87, 95% CI 1.09-7.54, p = 0.033) and a history of anaphylaxis (aOR: 7.84, 95% CI 1.86-33.04, p = 0.005) were related to confirmed AP hypersensitivity.</p><p><strong>Conclusion: </strong>Almost a quarter of children and adolescents were confirmed to have AP hypersensitivity. Older age, the presence of chronic urticaria and a history of anaphylaxis were potential risk factors for proven AP hypersensitivity.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1294-1306"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11096-024-01756-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Arylpropionic acid derivatives (APs) are the main triggers of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity. Data on clinical patterns and risk factors for AP hypersensitivity in children are quite limited.
Aim: To assess the clinical characteristics and potential risk factors for proven AP hypersensitivity in children.
Method: Patients with a history of AP hypersensitivity were retrospectively assessed using a standardized diagnostic algorithm. Children with confirmed hypersensitivity were defined as selective responders or cross-intolerants based on the result of drug provocation tests and further categorized according to the EAACI/ENDA classification. A multivariable logistic regression analysis was performed to analyze the potential risk factors for proven AP hypersensitivity.
Results: A total of 166 patients (51.2% male, median age of six years) with a history of AP hypersensitivity were included. Ibuprofen (89.2%) was the most frequently reported AP in the patients' histories. The reported hypersensitivity of 40 (22.4%) patients was confirmed by diagnostic testing: eight (13.6%) patients with a history of reaction only to APs and 32 (29.9%) patients with a history of reactions to multiple NSAIDs, including chemically unrelated NSAIDs in addition to APs. Five (12.5%) patients were classified as selective responders and 35 (87.5%) were cross-intolerants. Overall, five (12.5%) of the confirmed cases could not be categorized according to the EAACI/ENDA classification. Older age (aOR: 1.11, 95% CI 1.02-1.21, p = 0.015), chronic urticaria as an underlying disease (aOR: 2.87, 95% CI 1.09-7.54, p = 0.033) and a history of anaphylaxis (aOR: 7.84, 95% CI 1.86-33.04, p = 0.005) were related to confirmed AP hypersensitivity.
Conclusion: Almost a quarter of children and adolescents were confirmed to have AP hypersensitivity. Older age, the presence of chronic urticaria and a history of anaphylaxis were potential risk factors for proven AP hypersensitivity.
背景：芳基丙酸衍生物（AP）是导致非甾体抗炎药（NSAID）过敏的主要诱因。目的：评估已证实的儿童苯丙酸类药物过敏症的临床特征和潜在风险因素：方法：采用标准化诊断算法对有 AP 超敏病史的患者进行回顾性评估。根据药物激发试验的结果，将确诊过敏的儿童定义为选择性反应者或交叉耐受者，并根据 EAACI/ENDA 分类法进行进一步分类。为了分析已证实的 AP 过敏症的潜在风险因素，我们进行了多变量逻辑回归分析：共纳入了166名有AP过敏史的患者（51.2%为男性，中位年龄为6岁）。布洛芬（89.2%）是患者病史中最常报告的AP。40名（22.4%）患者的过敏史经诊断测试证实：8名（13.6%）患者仅对AP过敏，32名（29.9%）患者对多种非甾体抗炎药过敏，包括除AP外的化学性质无关的非甾体抗炎药。5名（12.5%）患者被归类为选择性反应者，35名（87.5%）患者为交叉不耐受者。总体而言，5 例（12.5%）确诊病例无法根据 EAACI/ENDA 分类进行分类。年龄较大（aOR：1.11，95% CI 1.02-1.21，p = 0.015）、慢性荨麻疹为基础疾病（aOR：2.87，95% CI 1.09-7.54，p = 0.033）和过敏性休克病史（aOR：7.84，95% CI 1.86-33.04，p = 0.005）与确诊的 AP 过敏症有关：结论：近四分之一的儿童和青少年被证实患有过敏性休克。年龄较大、患有慢性荨麻疹和过敏性休克病史是证实 AP 过敏症的潜在风险因素。
期刊介绍：
The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences.
IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy.
IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor.
International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy .
Until 2010 the journal was called Pharmacy World & Science.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
