The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Kimberly G Blumenthal - One of the best experts on this subject based on the ideXlab platform.
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controversies in Drug Allergy Drug Allergy pathways
The Journal of Allergy and Clinical Immunology: In Practice, 2019Co-Authors: Anca Mirela Chiriac, Aleena Banerji, Rebecca S Gruchalla, Bernard Yuhor Thong, Paige G Wickner, Paul Michel Mertes, Ingrid Terreehorst, Kimberly G BlumenthalAbstract:Drug Allergy pathways are standardized approaches for patients reporting prior Drug allergies with the aim of quality improvement and promotion of antibiotic stewardship. At the International Drug Allergy Symposium during the 2018 American Academy of Allergy, Asthma, and Immunology/World Allergy Organization Joint Congress in Orlando, Florida, Drug Allergy pathways were discussed from international perspectives with a focus on beta-lactam Allergy pathways and pragmatic approaches for acute care hospitals. In this expert consensus document, we review current pathways, and detail important considerations in devising, implementing, and evaluating beta-lactam Allergy pathways for hospitalized patients. We describe the key patient and institutional factors that must be considered in risk stratification, the central feature of pathway design. We detail shared obstacles to widespread beta-lactam Allergy pathway implementation and identify potential solutions to address these challenges.
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multiple Drug intolerance syndrome and multiple Drug Allergy syndrome epidemiology and associations with anxiety and depression
Allergy, 2018Co-Authors: Kimberly G Blumenthal, Aleena Banerji, Yu Li, Warren W Acker, Yuchiao Chang, Sharmin Ghaznavi, Carlos A Camargo, Li ZhouAbstract:Background The epidemiology of Multiple Drug Intolerance Syndrome (MDIS) and Multiple Drug Allergy Syndrome (MDAS) are poorly characterized. We used electronic health record (EHR) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression.
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economic impact of Drug Allergy
Drug Allergy Testing, 2018Co-Authors: Yu Li, Jasmit S Minhas, Kimberly G BlumenthalAbstract:The cost of adverse Drug reactions (ADRs) in the United States exceeds $4.2 billion annually. ADRs comprise 3–6% of all hospital admissions and complicate 10–15% of existing hospitalizations. Drug hypersensitivity reactions (HSRs) represent about 20% of ADRs and include anaphylaxis, angioedema, and cutaneous reactions that range from a mild Drug rash to severe cutaneous adverse reactions such as Stevens-Johnson syndrome/toxic epidermal necrolysis. HSR cost is determined by the resources required to diagnose and treat the patient's reaction. Ultimately, the type of medical visit required for HSR evaluation and treatment establishes much of the cost, with a simple doctor’s visit being less costly than an emergency department visit or hospitalization. HSR chronicity additionally impacts cost; therefore, acute urticaria from a nonsteroidal antiinflammatory Drug is less costly than a chemotherapy-induced delayed relapsing and remitting toxic dermatitis. Unverified Drug allergies result in costlier care and a large economic impact. The most common misreported Allergy is penicillin Allergy, which increases costs through the use of costlier alternative antibiotics and/or longer hospitalizations, which result from treatment failures, the development of Drug-resistant organisms, or healthcare-associated infections. To date, there have been few cost-effectiveness analyses in Drug Allergy, with most focusing on specific class I major histocompatibility complex molecules, including abacavir and HLA-B∗57:01, carbamazepine and HLA-B∗15:02, and allopurinol and HLAB∗58:01 and HLA-A∗31:01. Further economic analyses and cost-effective analyses related to Drug Allergy may help improve clinical outcomes and reduce healthcare costs.
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rising Drug Allergy alert overrides in electronic health records an observational retrospective study of a decade of experience
Journal of the American Medical Informatics Association, 2016Co-Authors: Paige G Wickner, Kimberly G Blumenthal, Maxim Topaz, Diane L Seger, Sarah P Slight, Foster R GossAbstract:Objective There have been growing concerns about the impact of Drug Allergy alerts on patient safety and provider alert fatigue. The authors aimed to explore the common Drug Allergy alerts over the last 10 years and the reasons why providers tend to override these alerts. Design : Retrospective observational cross-sectional study (2004–2013). Materials and Methods Drug Allergy alert data ( n = 611,192) were collected from two large academic hospitals in Boston, MA (USA). Results Overall, the authors found an increase in the rate of Drug Allergy alert overrides, from 83.3% in 2004 to 87.6% in 2013 ( P < .001). Alarmingly, alerts for immune mediated and life threatening reactions with definite allergen and prescribed medication matches were overridden 72.8% and 74.1% of the time, respectively. However, providers were less likely to override these alerts compared to possible (cross-sensitivity) or probable (allergen group) matches ( P < .001). The most common Drug Allergy alerts were triggered by allergies to narcotics (48%) and other analgesics (6%), antibiotics (10%), and statins (2%). Only slightly more than one-third of the reactions (34.2%) were potentially immune mediated. Finally, more than half of the overrides reasons pointed to irrelevant alerts (i.e., patient has tolerated the medication before, 50.9%) and providers were significantly more likely to override repeated alerts (89.7%) rather than first time alerts (77.4%, P < .001). Discussion and Conclusions These findings underline the urgent need for more efforts to provide more accurate and relevant Drug Allergy alerts to help reduce alert override rates and improve alert fatigue.
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effect of a Drug Allergy educational program and antibiotic prescribing guideline on inpatient clinical providers antibiotic prescribing knowledge
The Journal of Allergy and Clinical Immunology: In Practice, 2014Co-Authors: Kimberly G Blumenthal, Erica S Shenoy, Shelley Hurwitz, Christy Varughese, David C Hooper, Aleena BanerjiAbstract:Background Inpatient providers have varying levels of knowledge in managing patients with Drug and/or penicillin (PCN) Allergy. Objectives Our objectives were (1) to survey inpatient providers to ascertain their baseline Drug Allergy knowledge and preparedness in caring for patients with PCN Allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. Methods We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on Drug Allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin Allergy. Results Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in Drug Allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P P P = .03). Other areas, including understanding absolute contraindications to receiving a Drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Conclusions Inpatient providers have Drug Allergy knowledge deficits but are interested in tools to help them care for inpatients with Drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN Allergy knowledge in several crucial areas. To improve care of inpatients with Drug Allergy, more research is needed to evaluate hospital policies and sustainable educational tools.
Knut Brockow - One of the best experts on this subject based on the ideXlab platform.
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Drug Allergy passport and other documentation for patients with Drug hypersensitivity an enda eaaci Drug Allergy interest group position paper
Allergy, 2016Co-Authors: Knut Brockow, Werner Aberer, Marina Atanaskovicmarkovic, Sevim Bavbek, Andreas J Bircher, B Bilo, M Blanca, Patrizia Bonadonna, G J Burbach, Gianfranco CalogiuriAbstract:The strongest and best-documented risk factor for Drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to Drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of Drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a Drug Allergy passport as well as general guidelines of Drug Allergy documentation. A Drug Allergy passport, a Drug Allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A Drug Allergy passport should at least contain information on the culprit Drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative Drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full Allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
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Drug Allergy passport and other documentation for patients with Drug hypersensitivity - An ENDA/EAACI Drug Allergy Interest Group Position Paper
Allergy, 2016Co-Authors: Knut Brockow, Werner Aberer, Sevim Bavbek, Andreas J Bircher, B Bilo, M Blanca, Patrizia Bonadonna, G J Burbach, Marina Atanaskovic-markovic, Gianfranco CalogiuriAbstract:The strongest and best-documented risk factor for Drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to Drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of Drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a Drug Allergy passport as well as general guidelines of Drug Allergy documentation. A Drug Allergy passport, a Drug Allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A Drug Allergy passport should at least contain information on the culprit Drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative Drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full Allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
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international consensus on Drug Allergy
Allergy, 2014Co-Authors: P Demoly, Anca Mirela Chiriac, Knut Brockow, Mariana Castells, David A. Khan, N F Adkinson, Paul A Greenberger, David M Lang, Haesim Park, Werner J PichlerAbstract:When Drug reactions resembling Allergy occur, they are called Drug hypersensitivity reactions (DHRs) before showing the evidence of either Drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with Drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term ‘Allergy’) are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective Drugs, in contrast to patients who had undergone a complete Drug Allergy workup. Several guidelines and/or consensus documents on general or specific Drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on Drug Allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of DHRs.
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skin test concentrations for systemically administered Drugs an enda eaaci Drug Allergy interest group position paper
Allergy, 2013Co-Authors: Knut Brockow, Werner Aberer, Marina Atanaskovicmarkovic, Andreas J Bircher, M Blanca, L H Garvey, A Barbaud, M B Bilo, B Bonadonna, P CampiAbstract:Skin tests are of paramount importance for the evaluation of Drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of Drug Allergy is often based on history alone, which is an unreliable indicator of true hypersensitivity.To promote and standardize reproducible skin testing with safe and nonirritant Drug concentrations in the clinical practice, the European Network and European Academy of Allergy and Clinical Immunology (EAACI) Interest Group on Drug Allergy has performed a literature search on skin test Drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group.We recommend Drug concentration for skin testing aiming to achieve a specificity of at least 95%. It has been possible to recommend specific Drug concentration for betalactam antibiotics, perioperative Drugs, heparins, platinum salts and radiocontrast media. For many other Drugs, there is insufficient evidence to recommend appropriate Drug concentration. There
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pharmacovigilance of Drug Allergy and hypersensitivity using the enda dahd database and the galen platform the galenda project
Allergy, 2009Co-Authors: P J Bousquet, Knut Brockow, Werner Aberer, Andreas J Bircher, M Blanca, Werner J Pichler, Antonino Romano, P Demoly, M J Torres, I TerreehorstAbstract:Nonallergic hypersensitivity and allergic reactions are part of the many different types of adverse Drug reactions (ADRs). Databases exist for the collection of ADRs. Spontaneous reporting makes up the core data-generating system of pharmacovigilance, but there is a large under-estimation of Allergy/hypersensitivity Drug reactions. A specific database is therefore required for Drug Allergy and hypersensitivity using standard operating procedures (SOPs), as the diagnosis of Drug Allergy/hypersensitivity is difficult and current pharmacovigilance algorithms are insufficient. Although difficult, the diagnosis of Drug Allergy/hypersensitivity has been standardized by the European Network for Drug Allergy (ENDA) under the aegis of the European Academy of Allergology and Clinical Immunology and SOPs have been published. Based on ENDA and Global Allergy and Asthma European Network (GA(2)LEN, EU Framework Programme 6) SOPs, a Drug Allergy and Hypersensitivity Database (DAHD((R))) has been established under FileMaker((R)) Pro 9. It is already available online in many different languages and can be accessed using a personal login. GA(2)LEN is a European network of 27 partners (16 countries) and 59 collaborating centres (26 countries), which can coordinate and implement the DAHD across Europe. The GA(2)LEN-ENDA-DAHD platform interacting with a pharmacovigilance network appears to be of great interest for the reporting of Allergy/hypersensitivity ADRs in conjunction with other pharmacovigilance instruments.
Aleena Banerji - One of the best experts on this subject based on the ideXlab platform.
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advances in Drug Allergy urticaria angioedema and anaphylaxis in 2018
The Journal of Allergy and Clinical Immunology, 2019Co-Authors: Rachel L Miller, Maria Shtessel, Lacey B Robinson, Aleena BanerjiAbstract:Many notable advances in Drug Allergy, urticaria, angioedema, and anaphylaxis were reported in 2018. Broad-spectrum antibiotic use and, consequently, antibiotic resistance are widespread, and algorithms to clarify β-lactam Allergy and optimize antibiotic use were described. Meaningful data emerged on the pathogenesis of delayed Drug hypersensitivity reactions. Progress not only in defining biomarkers but also in understanding the effect on quality of life and developing better treatments has been made for patients with chronic idiopathic urticaria. Patients with hereditary angioedema (HAE) have gained additional access to highly efficacious therapies, with associated improvements in quality of life, and some progress was made in our understanding of recurrent angioedema in patients with normal laboratory results. Guidelines have defined clear goals to help providers optimize therapies in patients with HAE. The epidemiology and triggers of anaphylaxis and the mechanisms underlying anaphylaxis were elucidated further. In summary, these disorders (and labels) cause substantial burdens for individual persons and even society. Fortunately, publications in 2018 have informed on advancements in diagnosis and management and have provided better understanding of mechanisms that potentially could yield new therapies. This progress should lead to better health outcomes and paths forward in patients with Drug Allergy, urticaria, HAE, and anaphylaxis.
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controversies in Drug Allergy Drug Allergy pathways
The Journal of Allergy and Clinical Immunology: In Practice, 2019Co-Authors: Anca Mirela Chiriac, Aleena Banerji, Rebecca S Gruchalla, Bernard Yuhor Thong, Paige G Wickner, Paul Michel Mertes, Ingrid Terreehorst, Kimberly G BlumenthalAbstract:Drug Allergy pathways are standardized approaches for patients reporting prior Drug allergies with the aim of quality improvement and promotion of antibiotic stewardship. At the International Drug Allergy Symposium during the 2018 American Academy of Allergy, Asthma, and Immunology/World Allergy Organization Joint Congress in Orlando, Florida, Drug Allergy pathways were discussed from international perspectives with a focus on beta-lactam Allergy pathways and pragmatic approaches for acute care hospitals. In this expert consensus document, we review current pathways, and detail important considerations in devising, implementing, and evaluating beta-lactam Allergy pathways for hospitalized patients. We describe the key patient and institutional factors that must be considered in risk stratification, the central feature of pathway design. We detail shared obstacles to widespread beta-lactam Allergy pathway implementation and identify potential solutions to address these challenges.
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multiple Drug intolerance syndrome and multiple Drug Allergy syndrome epidemiology and associations with anxiety and depression
Allergy, 2018Co-Authors: Kimberly G Blumenthal, Aleena Banerji, Yu Li, Warren W Acker, Yuchiao Chang, Sharmin Ghaznavi, Carlos A Camargo, Li ZhouAbstract:Background The epidemiology of Multiple Drug Intolerance Syndrome (MDIS) and Multiple Drug Allergy Syndrome (MDAS) are poorly characterized. We used electronic health record (EHR) data to describe prevalences of MDIS and MDAS and to examine associations with anxiety and depression.
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report from the national institute of Allergy and infectious diseases workshop on Drug Allergy
The Journal of Allergy and Clinical Immunology, 2015Co-Authors: Lisa M Wheatley, Aleena Banerji, Mariana Castells, Marshall Plaut, Julie M Schwaninger, Fred D Finkelman, Gerald J Gleich, Emma Guttmanyassky, S MallalAbstract:Allergic reactions to Drugs are a serious public health concern. In 2013, the Division of Allergy, Immunology, and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop on Drug Allergy. International experts in the field of Drug Allergy with backgrounds in Allergy, immunology, infectious diseases, dermatology, clinical pharmacology, and pharmacogenomics discussed the current state of Drug Allergy research. These experts were joined by representatives from several National Institutes of Health institutes and the US Food and Drug Administration. The participants identified important advances that make new research directions feasible and made suggestions for research priorities and for development of infrastructure to advance our knowledge of the mechanisms, diagnosis, management, and prevention of Drug Allergy. The workshop summary and recommendations are presented herein.
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effect of a Drug Allergy educational program and antibiotic prescribing guideline on inpatient clinical providers antibiotic prescribing knowledge
The Journal of Allergy and Clinical Immunology: In Practice, 2014Co-Authors: Kimberly G Blumenthal, Erica S Shenoy, Shelley Hurwitz, Christy Varughese, David C Hooper, Aleena BanerjiAbstract:Background Inpatient providers have varying levels of knowledge in managing patients with Drug and/or penicillin (PCN) Allergy. Objectives Our objectives were (1) to survey inpatient providers to ascertain their baseline Drug Allergy knowledge and preparedness in caring for patients with PCN Allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. Methods We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on Drug Allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin Allergy. Results Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in Drug Allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P P P = .03). Other areas, including understanding absolute contraindications to receiving a Drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Conclusions Inpatient providers have Drug Allergy knowledge deficits but are interested in tools to help them care for inpatients with Drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN Allergy knowledge in several crucial areas. To improve care of inpatients with Drug Allergy, more research is needed to evaluate hospital policies and sustainable educational tools.
Jean Bousquet - One of the best experts on this subject based on the ideXlab platform.
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food and Drug Allergy and anaphylaxis in eaaci journals 2018
Pediatric Allergy and Immunology, 2019Co-Authors: Philippe Eigenmann, Jean Bousquet, Cezmi A Akdis, Clive Grattan, Karin Hoffmannsommergruber, Marek JutelAbstract:The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: "Allergy," "Pediatric Allergy and Immunology (PAI)," and "Clinical and Translational Allergy (CTA)." One of the major goals of EAACI is to support health promotion in which prevention of Allergy and asthma plays a critical role and to disseminate the knowledge of Allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2018 in anaphylaxis, and food and Drug Allergy. Main topics that have been focused are anaphylaxis, mechanisms of food Allergy (FA), epidemiology of FA, food allergens, diagnosis of FA, prevention and control of FA, FA immunotherapy, Drug Allergy, and political agenda.
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highlights and recent developments in food and Drug Allergy and anaphylaxis in eaaci journals 2017
Pediatric Allergy and Immunology, 2018Co-Authors: Philippe Eigenmann, Jean Bousquet, Cezmi A Akdis, Clive Grattan, Karin Hoffmannsommergruber, Peter Hellings, Ioana AgacheAbstract:This review highlights research advances and important achievements in food Allergy, anaphylaxis, and Drug Allergy that were published in the Journals of the European Academy of Allergy and Clinical Immunology (EAACI) in 2017. Food Allergy and anaphylaxis research have continued to rapidly accelerate, with increasing numbers of outstanding developments in 2017. We saw new studies on the mechanisms, diagnosis, prevention of food Allergy, and novel food allergens. Drug hypersensitivity, as well as hereditary angioedema, has been highlighted in the present review as the focus of recent developments. The EAACI owns three journals: Allergy, Pediatric Allergy and Immunology (PAI), and Clinical and Translational Allergy (CTA). One of the major goals of the EAACI is to support health promotion in which prevention of Allergy and asthma plays a critical role and to disseminate the knowledge of Allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2017 in anaphylaxis, and food and Drug Allergy.
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Drug Allergy diagnosis work up
Allergy, 2002Co-Authors: Pascal Demoly, Jean BousquetAbstract:Drug hypersensitivity reactions are a daily worry for clinicians. The tools allowing a definitive diagnosis are few and poorly validated. They include a thorough clinical history, standardized skin tests, reliable biological test, and sometimes Drug provocation tests. These tools are currently being evaluated by the European Network of Drug Allergy, under the aegis of the EAACI Drug hpersensitivity group of interest.
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predictive capacity of histamine release for the diagnosis of Drug Allergy
Allergy, 1999Co-Authors: P Demoly, B Lebel, D Messaad, H Sahla, M Rongier, J P Daures, P Godard, Jean BousquetAbstract:Background: The diagnosis of immediate allergic reactions to Drugs is difficult, requiring in vitro test development. Basophils are likely to be involved in these reactions, and to evaluate the sensitivity, the specificity, and the predictive values of the histamine-release test, we performed a prospective study in 68 patients tested for suspected Drug Allergy. Methods: Positive diagnosis was established by history, skin tests, and, if needed, oral provocation tests. Histamine release in the presence of the Drug was assessed on heparinized whole blood by enzyme immunoassay (Immunotech, France), and the cutoff value was set at 5% of total histamine content. Spontaneous and anti-IgE-induced histamine release was also studied in all subjects. Results: All patients presented to our clinic with reactions ranging from maculopapular exanthema to anaphylactic shock. Thirty-five patients had proven Drug Allergy; 33 were not allergic to Drugs and served as a control group together with 40 other subjects with no history of Drug Allergy. Net histamine release was positive in 18/35 allergics and 27/73 nonallergics, giving poor sensitivity (51.4%), specificity (63.0%), and positive predictive value (29.3%), but valuable negative predictive value (81.1%). Conclusions: The usefulness of the in vitro histamine-release test for the diagnosis of Drug Allergy appears to be insufficient.
Werner Aberer - One of the best experts on this subject based on the ideXlab platform.
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The Drug ambassador project: the diversity of diagnostic procedures for Drug Allergy around Europe
Allergy & Clinical Immunology International-journal of The World Allergy Organization, 2020Co-Authors: Eva Rebelo Gomes, Werner Aberer, Werner J Pichler, Pascal Demoly, Anthony J. Frew, Alain L. De Weck, Barbara Ballmer-weber, Annick Barbaud, B. M. Bilo, Andreas J BircherAbstract:Background: Drug Allergy is an increasingly important clinical problem. About 5-10% of patients consulting Allergy centers have some form of Drug Allergy or pseudo Allergy. At present there is no consensus concerning the best way to study and diagnose hypersensitivity reactions to Drugs. This leads both to practical difficulties in diagnosing individual patients and to more general problems in comparing protocols and results from different centers. Methods/Data base: The European Network for Drug Allergy (ENDA) Drug Ambassador Project aimed to collect information on the ways that different European centers approach these patients. Results: The present report summarizes data collected during this project, focussing on the organization of Drug Allergy consultations, diagnostic protocols and the various in vitro and in vivo investigation procedures in current use. The study revealed wide variation in the diagnostic procedures used for Drug Allergy in clinical practice, despite the apparent consensus achieved in recommendations and position papers. Conclusion: Reciprocal exchange of information and discussions based on these observations may help to achieve standardization and harmonization in this sector with significant potential benefits for patients with Drug allergies.
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Drug Allergy passport and other documentation for patients with Drug hypersensitivity an enda eaaci Drug Allergy interest group position paper
Allergy, 2016Co-Authors: Knut Brockow, Werner Aberer, Marina Atanaskovicmarkovic, Sevim Bavbek, Andreas J Bircher, B Bilo, M Blanca, Patrizia Bonadonna, G J Burbach, Gianfranco CalogiuriAbstract:The strongest and best-documented risk factor for Drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to Drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of Drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a Drug Allergy passport as well as general guidelines of Drug Allergy documentation. A Drug Allergy passport, a Drug Allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A Drug Allergy passport should at least contain information on the culprit Drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative Drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full Allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
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Drug Allergy passport and other documentation for patients with Drug hypersensitivity - An ENDA/EAACI Drug Allergy Interest Group Position Paper
Allergy, 2016Co-Authors: Knut Brockow, Werner Aberer, Sevim Bavbek, Andreas J Bircher, B Bilo, M Blanca, Patrizia Bonadonna, G J Burbach, Marina Atanaskovic-markovic, Gianfranco CalogiuriAbstract:The strongest and best-documented risk factor for Drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to Drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of Drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a Drug Allergy passport as well as general guidelines of Drug Allergy documentation. A Drug Allergy passport, a Drug Allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A Drug Allergy passport should at least contain information on the culprit Drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative Drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full Allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
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skin test concentrations for systemically administered Drugs an enda eaaci Drug Allergy interest group position paper
Allergy, 2013Co-Authors: Knut Brockow, Werner Aberer, Marina Atanaskovicmarkovic, Andreas J Bircher, M Blanca, L H Garvey, A Barbaud, M B Bilo, B Bonadonna, P CampiAbstract:Skin tests are of paramount importance for the evaluation of Drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of Drug Allergy is often based on history alone, which is an unreliable indicator of true hypersensitivity.To promote and standardize reproducible skin testing with safe and nonirritant Drug concentrations in the clinical practice, the European Network and European Academy of Allergy and Clinical Immunology (EAACI) Interest Group on Drug Allergy has performed a literature search on skin test Drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group.We recommend Drug concentration for skin testing aiming to achieve a specificity of at least 95%. It has been possible to recommend specific Drug concentration for betalactam antibiotics, perioperative Drugs, heparins, platinum salts and radiocontrast media. For many other Drugs, there is insufficient evidence to recommend appropriate Drug concentration. There
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pharmacovigilance of Drug Allergy and hypersensitivity using the enda dahd database and the galen platform the galenda project
Allergy, 2009Co-Authors: P J Bousquet, Knut Brockow, Werner Aberer, Andreas J Bircher, M Blanca, Werner J Pichler, Antonino Romano, P Demoly, M J Torres, I TerreehorstAbstract:Nonallergic hypersensitivity and allergic reactions are part of the many different types of adverse Drug reactions (ADRs). Databases exist for the collection of ADRs. Spontaneous reporting makes up the core data-generating system of pharmacovigilance, but there is a large under-estimation of Allergy/hypersensitivity Drug reactions. A specific database is therefore required for Drug Allergy and hypersensitivity using standard operating procedures (SOPs), as the diagnosis of Drug Allergy/hypersensitivity is difficult and current pharmacovigilance algorithms are insufficient. Although difficult, the diagnosis of Drug Allergy/hypersensitivity has been standardized by the European Network for Drug Allergy (ENDA) under the aegis of the European Academy of Allergology and Clinical Immunology and SOPs have been published. Based on ENDA and Global Allergy and Asthma European Network (GA(2)LEN, EU Framework Programme 6) SOPs, a Drug Allergy and Hypersensitivity Database (DAHD((R))) has been established under FileMaker((R)) Pro 9. It is already available online in many different languages and can be accessed using a personal login. GA(2)LEN is a European network of 27 partners (16 countries) and 59 collaborating centres (26 countries), which can coordinate and implement the DAHD across Europe. The GA(2)LEN-ENDA-DAHD platform interacting with a pharmacovigilance network appears to be of great interest for the reporting of Allergy/hypersensitivity ADRs in conjunction with other pharmacovigilance instruments.
