Accuracy of a Pharmacovigilance Algorithm in Diagnosing Drug Hypersensitivity Reactions

Abstract

A pharmacovigilance algorithm is not accurate for the diagnosis of drug hypersensitivity reactions and cannot replace drug allergy testing.

Treatment of adverse drug reactions in a dermatology department

“…Due to polypharmacy in 17.4% of the studied patients the ADR received a lower level of probability by the Naranjo scale, and this finding is in line with the results of Fiszenson et al, who confirm the difficulties to attest the imputability of a drug especially when there is concomitant use of multiple drugs [11]. The high proportion of "type B" reactions may also be the reason for this considerably low level of probability of drug causation because the algorithms used for establishing drug causality are adjusted for pharmacologically dependent ADRs [12] and cannot replace allergy testing in hypersensitivity reactions [13]. Drug provocation tests were not performed for ethical reasons and this resulted in a rather low proportion of "definite" ADRs.…”

Dermal dendrocytes FXIIIA+ phagocytizing extruded mast cell granules in drug‐induced acute urticaria

“…Similarly, our finding that the remnants of granules expelled into extracellular fluid in normal skin and urticarial lesions of DIAU were subsequently phagocytized by DD rely on earlier results 23 that during mast cell degranulation the soluble component of the granule is released into the extracellular fluid, whereas two neutral proteases and heparin proteoglycans form the extracellular granule remnants, negatively charged and with high affinity bind to low density lipoprotein and other basic molecules 19 . Also, mast cell granule phagocytosis by DD was found others immune conditions, such as toxic epidermal necrolysis and graft‐versus‐host reaction 24 …”

Drug allergy claims in children: from self‐reporting to confirmed diagnosis

“…This is also the case for pharmacovigilance algorithms in use [39,40], emphasizing the need for an exhaustive diagnostic work-up including oral provocation tests. This indicates the need for trained professionals and facilities to respond promptly to increasing solicitations.…”