Epidemiology of hypersensitivity drug reactions

Purpose of reviewHypersensitivity drug reactions are but one of the many different types of adverse drug reactions. They may be potentially life-threatening, prolong hospitalization, affect drug prescribing patterns of physicians and result in socioeconomic costs. This review summarizes current knowledge on the incidence, prevalence, mortality and risk factors for these reactions in different populations. Recent findingsHypersensitivity reactions represent about one third of all adverse drug reactions. Adverse drug reactions affect 10–20% of hospitalized patients and more than 7% of the general population. Severe reactions including anaphylaxis, drug hypersensitivity syndromes, Stevens Johnson syndrome and toxic epidermal necrolysis are also associated with significant morbidity and mortality. Although several risk factors have been identified, their clinical importance has not been fully understood. Future progress in immunogenetics and pharmacogenetics may help identify populations at risk for specific types of reactions. SummaryWell designed epidemiological studies on hypersensitivity drug reactions are lacking as most studies have been on adverse drug reactions. Such studies will be helpful in identifying patients at risk of developing such reactions, in particular severe reactions, and implementing early preventive measures.

[1]  P. Demoly,et al.  Self‐reported drug allergy in a general adult Portuguese population , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[2]  H. Hong,et al.  Acute Generalized Exanthematous Pustulosis Induced by Topical Lindane , 2004, Dermatology.

[3]  A. Adam,et al.  Angiotensin-Converting Enzyme Inhibitor-Associated Angioedema Is Characterized by a Slower Degradation of des-Arginine9-Bradykinin , 2002, Journal of Pharmacology and Experimental Therapeutics.

[4]  Thomas Bieber,et al.  Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. , 2004, The Journal of allergy and clinical immunology.

[5]  A. Neugut,et al.  Epidemiology of anaphylaxis in the united states , 2003, Current allergy and asthma reports.

[6]  J. Bousquet,et al.  Epidemiology of drug allergy , 2001, Current opinion in allergy and clinical immunology.

[7]  R. Schwartz,et al.  Antibiotic rashes in children: a survey in a private practice setting. , 2000, Archives of dermatology.

[8]  J. Hayes,et al.  Frequency and Preventability of Adverse Drug Reactions in Paediatric Patients , 2004, Drug safety.

[9]  The Value of Reporting Therapeutic Ineffectiveness as an Adverse Drug Reaction , 2000, Drug safety.

[10]  M. Sanak,et al.  Leukotriene C 4 synthase promoter polymorphism and risk of aspirin-induced asthma , 1997, The Lancet.

[11]  R. Lockey,et al.  Anaphylaxis. A review of 266 cases. , 1995, Archives of internal medicine.

[12]  H. Chng,et al.  Drug allergy in a general hospital: Results of a novel prospective inpatient reporting system. , 2003, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[13]  N. Gogtay,et al.  Anticonvulsant Hypersensitivity Syndrome: Lymphocyte Toxicity Assay for the Confirmation of Diagnosis and Risk Assessment , 2004, The Annals of pharmacotherapy.

[14]  M. Le Bourgeois,et al.  Allergy to β-Lactam Antibiotics in Children , 1999, Pediatrics.

[15]  J. Fahrenholz Natural history and clinical features of aspirin-exacerbated respiratory disease , 2003, Clinical reviews in allergy & immunology.

[16]  A. Weck Pharmacologic and immunochemical mechanisms of drug hypersensitivity , 1991 .

[17]  S. Ross,et al.  Drug-related adverse events: a readers' guide to assessing literature reviews and meta-analyses. , 2001, Archives of internal medicine.

[18]  Z. Temesgen,et al.  HIV and drug allergy. , 2004, Immunology and allergy clinics of North America.

[19]  E. Novembre,et al.  Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985-1996). , 2001, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[20]  P. Barach,et al.  Clarifying Adverse Drug Events: A Clinician's Guide to Terminology, Documentation, and Reporting , 2004, Annals of Internal Medicine.

[21]  J. Bousquet,et al.  Drug Provocation Tests in Patients with a History Suggesting an Immediate Drug Hypersensitivity Reaction , 2004, Annals of Internal Medicine.

[22]  M. Lapeyre-Mestre,et al.  Assessing the Feasibility of Using an Adverse Drug Reaction Preventability Scale in Clinical Practice , 2002, Drug safety.

[23]  H. Jick,et al.  A population-based study of the incidence, cause, and severity of anaphylaxis in the United Kingdom. , 2004, Archives of internal medicine.

[24]  W. Pichler,et al.  Incidence of anaphylaxis with circulatory symptoms: a study over a 3‐year period comprising 940 000 inhabitants of the Swiss Canton Bern , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[25]  R. Asero Detection of patients with multiple drug allergy syndrome by elective tolerance tests. , 1998, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[26]  B. Stricker,et al.  Drug‐associated anaphylaxis: 20 years of reporting in the Netherlands (1974–1994) and review of the literature , 1996, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[27]  Y. Mizukawa,et al.  Virus-induced immune dysregulation as a triggering factor for the development of drug rashes and autoimmune diseases: with emphasis on EB virus, human herpesvirus 6 and hepatitis C virus. , 2000, Journal of dermatological science.

[28]  M. Sánchez-Borges,et al.  Atopy is a risk factor for non-steroidal anti-inflammatory drug sensitivity. , 2000, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[29]  T. Mjörndal,et al.  Under‐reporting of serious adverse drug reactions in Sweden , 2004, Pharmacoepidemiology and drug safety.

[30]  M. Kidon,et al.  Adverse drug reactions in Singaporean children. , 2004, Singapore medical journal.

[31]  R. Hayward,et al.  Estimating hospital deaths due to medical errors: preventability is in the eye of the reviewer. , 2001, JAMA.

[32]  M. Britschgi,et al.  Molecular aspects of drug recognition by specific T cells. , 2003, Current drug targets.

[33]  C. Taxonera,et al.  Genetic predisposition to acute gastrointestinal bleeding after NSAIDs use , 2004, British journal of pharmacology.

[34]  A. Neugut,et al.  Anaphylaxis in the United States: an investigation into its epidemiology. , 2001, Archives of internal medicine.

[35]  D. Moneret-vautrin,et al.  Adult food allergy , 2005, Current allergy and asthma reports.

[36]  P. Corey,et al.  Incidence of Adverse Drug Reactions in Hospitalized Patients , 2012 .

[37]  Kay Brune,et al.  Lack of Awareness of Community-Acquired Adverse Drug Reactions Upon Hospital Admission , 2003, Drug safety.

[38]  S. Schroeder,et al.  How Many Hours Is Enough? An Old Profession Meets a New Generation , 2004, Annals of Internal Medicine.

[39]  C. Sabbà,et al.  Allergic and pseudoallergic reactions induced by glucocorticoids: a review. , 2003, Current pharmaceutical design.

[40]  H. Falcão,et al.  Drug allergy in university students from Porto, Portugal , 2003, Allergy.

[41]  R. Pumphrey Anaphylaxis: can we tell who is at risk of a fatal reaction? , 2004, Current opinion in allergy and clinical immunology.

[42]  M. Pichichero,et al.  Diagnosis of penicillin, amoxicillin, and cephalosporin allergy: reliability of examination assessed by skin testing and oral challenge. , 1998, The Journal of pediatrics.

[43]  R E Ferner,et al.  Joining the DoTS: new approach to classifying adverse drug reactions , 2003, BMJ : British Medical Journal.

[44]  M. Pirmohamed,et al.  Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients , 2004, BMJ : British Medical Journal.

[45]  M. Roos,et al.  Adverse drug events caused by medication errors in medical inpatients. , 2004, Swiss medical weekly.

[46]  A. Sheikh,et al.  Hospital admissions for acute anaphylaxis: time trend study , 2000, BMJ : British Medical Journal.

[47]  D. Bates,et al.  An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. , 2004, Journal of evaluation in clinical practice.

[48]  William B Runciman,et al.  Adverse drug events and medication errors in Australia. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[49]  I. Edwards,et al.  Adverse drug reactions: definitions, diagnosis, and management , 2000, The Lancet.

[50]  F. Follath,et al.  Epidemiology of drug exposure and adverse drug reactions in two swiss departments of internal medicine. , 2000, British journal of clinical pharmacology.

[51]  P. Burke,et al.  Allergy associated with ciprofloxacin , 2000, BMJ : British Medical Journal.

[52]  R S Evans,et al.  Computerized surveillance of adverse drug events in hospital patients. 1991. , 1991, Quality & safety in health care.

[53]  R. Stern,et al.  Severe adverse cutaneous reactions to drugs. , 1994, The New England journal of medicine.

[54]  D. Charpin,et al.  Atopy and systemic reactions to drugs , 1990, Allergy.

[55]  R. Stern,et al.  Cutaneous disease and drug reactions in HIV infection. , 1993, The New England journal of medicine.

[56]  D. Thorburn,et al.  Epidemiological risk factors for hypersensitivity reactions to abacavir * , 2003, HIV medicine.

[57]  M. Markowitz Allergic reactions to long-term benzathine penicillin prophylaxis for rheumatic fever , 1991 .

[58]  Y. Çağ,et al.  Penicillin sensitivity among children without a positive history for penicillin allergy , 2004, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[59]  W. Rascher,et al.  Survey of adverse drug reactions on a pediatric ward: a strategy for early and detailed detection. , 2002, Pediatrics.

[60]  P. Neuvonen,et al.  Drug-related deaths in a university central hospital , 2002, European Journal of Clinical Pharmacology.

[61]  D. Margolis,et al.  Represcription of penicillin after allergic-like events. , 2004, The Journal of allergy and clinical immunology.

[62]  M. Dykewicz Cough and angioedema from angiotensin-converting enzyme inhibitors: new insights into mechanisms and management , 2004, Current opinion in allergy and clinical immunology.

[63]  R. Farinotti,et al.  A 6‐month prospective survey of cutaneous drug reactions in a hospital setting , 2003, The British journal of dermatology.

[64]  P Impicciatore,et al.  Incidence of adverse drug reactions in paediatric in/out-patients: a systematic review and meta-analysis of prospective studies. , 2001, British journal of clinical pharmacology.

[65]  N. Laird,et al.  Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention , 1995 .

[66]  R. Primosch,et al.  Allergic reaction to intranasal midazolam HCl: a case report. , 2004, Pediatric dentistry.

[67]  A. Filippelli,et al.  Hospital-based intensive monitoring of antibiotic-induced adverse events in a university hospital. , 2005, Pharmacological research.

[68]  Manuel Gomez,et al.  Evaluation of the Extent of Under-Reporting of Serious Adverse Drug Reactions , 2004, Drug safety.

[69]  M. Pirmohamed,et al.  TNFα promoter region gene polymorphisms in carbamazepine-hypersensitive patients , 2001, Neurology.

[70]  K. Arndt,et al.  Drug-induced cutaneous reactions. A report from the Boston Collaborative Drug Surveillance Program on 15,438 consecutive inpatients, 1975 to 1982. , 1986, JAMA.

[71]  I. James,et al.  Predisposition to abacavir hypersensitivity conferred by HLA-B*5701 and a haplotypic Hsp70-Hom variant , 2004, Proceedings of the National Academy of Sciences of the United States of America.

[72]  E. Pérez-Inestrosa,et al.  Immediate allergic reactions to betalactams: facts and controversies , 2004, Current opinion in allergy and clinical immunology.

[73]  T. Kozuka,et al.  Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. , 1990, Radiology.

[74]  W A Ray,et al.  Black Americans have an increased rate of angiotensin converting enzyme inhibitor‐associated angioedema , 1996, Clinical pharmacology and therapeutics.

[75]  F. Alla,et al.  Anaphylactic and Anaphylactoid Reactions Occurring during Anesthesia in France in 1999–2000 , 2003, Anesthesiology.

[76]  N. Moore,et al.  Frequency and cost of serious adverse drug reactions in a department of general medicine. , 1998, British journal of clinical pharmacology.

[77]  H. Sørensen,et al.  Drug-related fatal anaphylactic shock in Denmark 1968-1990. A study based on notifications to the Committee on Adverse Drug Reactions. , 1995, Journal of clinical epidemiology.

[78]  Pumphrey Lessons for management of anaphylaxis from a study of fatal reactions , 2000, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.