New Insights Into Immunomodulatory Strategies for Drug Hypersensitivity Reactions: An EAACI Task Force Report

Abstract

Drug hypersensitivity reactions (DHRs) are a global health concern and remain challenging to investigate owing to the heterogeneity of endotypes and phenotypes, as well as the lack of standardized biomarkers. Until recently, strict drug avoidance was the only management strategy for severe DHRs. However, the development of novel therapeutic options, including biologics and drug desensitization protocols, has shown promising results, particularly when no alternatives exist. In parallel, the search for reliable biomarkers for diagnosis and monitoring immunomodulatory strategies is essential to improve patient care. Advances in the algorithms and digital tools also offer opportunities for enhanced risk stratification and more efficient delabeling of patients who may be incorrectly classified as allergic. In this review, we summarize recent advances in the classification of DHRs, discuss current and emerging immunomodulatory strategies for their management, and highlight relevant biomarkers, emphasizing the need to integrate them into clinical practice.