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Pearls for practice from the 2022 joint task force drug allergy practice parameter.
Ziwei Wang1, Marcus Shaker2,3, Karen Hsu Blatman2,3
1Division of Allergy and Immunology, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Current Opinion in Pediatrics
|March 17, 2023
Summary
The 2022 Drug Allergy Practice Parameter offers updated guidance for evaluating and managing drug hypersensitivity reactions. It emphasizes patient history and favors drug challenges over skin testing for non-severe reactions.
Area of Science:
- Allergy and Immunology
- Clinical Pharmacology
- Pharmacovigilance
Background:
- Adverse drug reactions are a growing concern with novel therapeutics.
- Drug hypersensitivity reactions represent a significant portion of adverse drug events, impacting patients and healthcare systems.
- Reactions vary in presentation, with immediate (≤6 hours) and delayed (>6 hours to months) onsets.
Framework:
- The 2022 Drug Allergy Practice Parameter provides consensus-based recommendations.
- Covers evaluation of hypersensitivity to antibiotics, NSAIDs, chemotherapy, immune checkpoint inhibitors, biologics, and excipients.
- Highlights the critical role of patient history in determining reaction phenotype and severity.
Implementation:
- Emphasizes detailed patient history to elucidate reaction characteristics.
- Recommends drug challenge as the gold standard for diagnosis.
- Favors drug challenge over skin testing for non-severe, non-anaphylactic reactions.
Implications:
- Provides an updated framework for clinical practice in managing drug hypersensitivity.
- Aims to improve patient care and reduce the negative impact of adverse drug reactions.
- Supports evidence-based decision-making for healthcare professionals.
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