Immediate moxifloxacin hypersensitivity: Is there more than currently meets the eye?

Gasse, Athina L. Van; Sabato, Vito; Uyttebroek, Astrid P.; Elst, Jessy; Faber, Margaretha A.; Hagendorens, Margo M.; Mertens, Christel; Bridts, Chris H.; Clerck, Luc S. De; Ebo, Didier G.

doi:10.1111/all.13236

Cited by 39 publications

(49 citation statements)

References 19 publications

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“…Therefore, unlike IgE-dependent reactions, DHR from MRGPRX2 occupancy will probably yield negative BAT results. 76 BATs are not useful for evaluation of nonallergic hypersensitivity to NSAIDs. 9,73 BATs show a low sensitivity when including one NSAID in the test, [77][78][79][80] and although the sensitivity could increase when including several NSAIDs, the specificity decreases dramatically.…”

Section: Batsmentioning

confidence: 99%

Controversies in drug allergy: In vitro testing

Mayorga

Ebo

Lang

et al. 2019

Journal of Allergy and Clinical Immunology

107

106

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Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions and should identify the culprit drug or drugs and safe alternatives. However, making the diagnosis can be complex and challenging. Reliable in vitro tests can offer the potential to improve a diagnosis of DHR and influence medical decision making. Importantly, in vitro testing is frequently not performed as a test in isolation but rather as a component of a diagnostic algorithm along with additional tests. There are several in vitro approaches for the different endotypes of DHRs. However, only few are available for routine diagnosis, and many are restricted to research laboratories. In vitro tests exhibit varying sensitivity and specificity depending on the drug involved and the clinical phenotype. In vitro tests can complement skin tests, especially in patients with negative or equivocal skin test responses inconsistent with the clinical presentation and in severe reactions in which drug provocation tests are contraindicated. The main unmet need for many in vitro tests for the diagnosis of DHRs is validation in larger studies with standardized controls that could harmonize diagnostic management between the United States, European Union, and other regions of the world.

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Section: Batsmentioning

confidence: 99%

Controversies in drug allergy: In vitro testing

Mayorga

Ebo

Lang

et al. 2019

Journal of Allergy and Clinical Immunology

107

106

View full text Add to dashboard Cite

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“…Nonirritating concentrations for STs have been determined for a large range of drugs (eg BLs, perioperative drugs, heparins, platinum salts and RCM) . However, they are not standardized for all drugs and can produce false‐positive results as a consequence of nonspecific histamine release from mast cells, as observed with quinolones …”

Section: Diagnosismentioning

confidence: 99%

“…77 However, they are not standardized for all drugs 13,78 and can produce false-positive results as a consequence of nonspecific histamine release from mast cells, as observed with quinolones. 79 Penicillin allergy testing has a favourable cost-benefit ratio for the incremental cost of testing versus future healthcare utilization. 80 The role of STs in RCM reactions is controversial since although previous data demonstrated a sensitivity of around 50%, 81 a recent study found only 13.4% with a NPV of 93.1%.…”

Section: In Vivo Testsmentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Mayorga

Fernandez

Montañez

et al. 2019

Allergy

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Drug hypersensitivity reactions (DHRs) are nowadays the third cause of allergy after rhinitis and asthma with a significant increase in prevalence in both adults and paediatric population with new drugs included as culprit. For this, DHRs represent not only a health problem but also a significant financial burden for affected individuals and health systems. Mislabelling DHRs is showing to be a relevant problem for both, false label of drug allergic and false label of nonallergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management.Moreover, there is a need for training both, nonallergist stakeholders and patients to improve the reaction identification and therefore decrease the mislabelling. The use of allergy cards has shown to be relevant to avoid the induction of DHRs due to the prescription of wrong medication.Recent developments over the last 2 years and highlights about risk factors, diagnostic approaches, mechanisms involved as well as prevention actions, and management have been reviewed. In these papers, it has been outlined the need for correct diagnosis and de-labelling of patients previously false-reported as allergic, which will improve the management and treatment of patients with DHRs. K E Y W O R D Sallergy diagnosis, allergy treatment, basic mechanisms, drug allergy, epidemiology | 2369

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“…140 The diagnosis of DHR is mainly based on skin tests and drug provocation tests, methods that are not free of risk, still lack standardization, and differ depending on the drug, mechanisms, and even the health system. [142][143][144] There is an urgent need for developing new in vitro diagnostic tests or improving those already existing, 138 such as basophil activation test, 145,146 to improve the diagnostic workup.…”

Section: New Approaches To the Diagnosis And Treatment Of Drug Hypementioning

confidence: 99%

Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care

Breiteneder

Diamant

Eiwegger

et al. 2019

Allergy

101

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This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. AbstractThe specialties of allergy and clinical immunology have entered the era of precision medicine with the stratification of diseases into distinct disease subsets, specific diagnoses, and targeted treatment options, including biologicals and small molecules.This article reviews recent developments in research and patient care and future trends in the discipline. The section on basic mechanisms of allergic diseases summarizes the current status and defines research needs in structural biology, type 2 inflammation, immune tolerance, neuroimmune mechanisms, role of the microbiome and diet, environmental factors, and respiratory viral infections. In the section on diagnostic challenges, clinical trials, precision medicine and immune monitoring Zuzana Diamanthttps://orcid.org/0000-0003-0133-0100Thomas Eiwegger https://orcid.org/0000-0002-2914-7829Wytske J. Fokkens https://orcid.org/0000-0003-4852-229X

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Immediate moxifloxacin hypersensitivity: Is there more than currently meets the eye?

Cited by 39 publications

References 19 publications

Controversies in drug allergy: In vitro testing

Controversies in drug allergy: In vitro testing

Recent developments and highlights in drug hypersensitivity

Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care

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