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

ABSTRACT: Background: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-speci?c 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.

SUBMITTER: Tang MM

PROVIDER: S-EPMC7610088 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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

Tang Min-Moon MM Fok Jie Shen JS Thong Bernard Yu-Hor BY Yun James J Li Philip Hei PH Kang Hye-Ryun HR Thien Francis F Yamaguchi Masao M Lucas Michaela M Chang Yoon-Seok YS Kim Byung-Keun BK Nagao Mizuho M Rengganis Iris I Tsai Yi-Giien YG Chung Wen-Hung WH Rerkpattanapipat Ticha T Kamchaisatian Wasu W Leung Ting Fan TF Ho Joo-Yoon JY Zhang Luo L Latiff Amir Hamzah Abdul AHA Fujisawa Takao T Castells Mariana C MC Demoly Pascal P Wang Jiu Yao JY Pawankar Ruby R

Asia Pacific allergy 20201015 4

<h4>Background</h4>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.<h4>Objective</h4>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).<h4>Methods</h4>A questionnaire comprising 41 questions was circu ...[more]

PMID: 33178561

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

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

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