Incidence of adverse cutaneous drug reactions in 22,866 Chinese inpatients: a prospective study

Abstract

Cutaneous adverse drug reactions (ADRs) are common. However, no prospective study assessing cutaneous ADRs is available for Chinese populations. This study aimed to assess the incidence, manifestations, causative drugs, and other factors related to cutaneous ADRs. A total of 22,866 inpatients were surveyed prospectively from January to April 2012 at the Peking Union Medical College Hospital. Only cutaneous ADRs induced by systemic drugs were considered. Fifty cases were confirmed as cutaneous ADRs, for an estimated incidence of 2.2 per 1000 during this period (95 % confidence interval 1.6-2.8). Cases of cutaneous ADRs comprised 69 % females, while 63 % of all inpatients were female (χ (2) = 0.641, P = 0.427). The department of infectious diseases was the most frequently involved department. Morbilliform exanthema (40 %) was the most frequent cutaneous ADR, followed by urticaria (23.1 %). Anti-infection drugs (36.9 %) caused most cases of cutaneous ADRs, followed by iodinated contrast media (ICM, 18.5 %) and non-steroidal anti-inflammatory drugs (NSAIDs, 18.5 %). The most frequently associated disorders were cancer (24 %), infection (22 %), cardiovascular and cerebrovascular diseases (20 %), and autoimmune diseases (18 %). In this first prospective study assessing the incidence of cutaneous ADRs in China, anti-infection drugs were the most commonly involved drugs, followed by ICM and NSAIDs. No evidence of increased cutaneous ADR incidence in AIDS or SLE patients was observed. Our findings indicate that cancer and its treatments were often related to cutaneous ADRs in China.

Spontaneous cutaneous adverse drug reaction reports—An analysis of a 10‐year dataset in Singapore

“…These tend to be associated with nonserious CADRs such as angioedema, urticaria, FDE, and bullous eruption (Table ). In comparison, a study by Ding et al focusing on CADRs in a tertiary hospital reported antibiotics, antiepileptics and antigout drugs as the top drug classes implicated, highlighting the difference in the propensity of different drug classes to cause serious CADRs requiring hospitalization.…”

“…The manifestation of CADRs can be very varied, ranging from mild, self‐limiting reactions to severe cutaneous adverse reactions (SCARs) associated with significant morbidity and mortality, such as acute generalized exanthematous pustulosis (AGEP), Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug hypersensitivity syndrome (DHS). CADRs are also associated with a wide range of drugs, with antimicrobials, NonSteroidal Anti‐Inflammatory Drugs (NSAIDs), antiepileptics, and analgesics as the most frequently implicated drug classes . While much is known about CADRs, information on the types of CADRs reported through the spontaneous ADR reporting system is limited.…”

“…CADRs are also associated with a wide range of drugs, with antimicrobials, NonSteroidal Anti-Inflammatory Drugs (NSAIDs), antiepileptics, and analgesics as the most frequently implicated drug classes. [8][9][10][11][12] While much is known about CADRs, information on the types of CADRs reported through the spontaneous ADR reporting system is limited. We seek to fill this knowledge gap with an analysis of a large dataset with over 100 000 CADR reports from a 10-year period from the HSA AE database.…”

Dermoscopic Aspects of Cutaneous Adverse Drug Reactions

“…The incidence of CADRs among hospitalized patients ranges from 0.14% to 3.3% and from 0.14% to 1.05% in outpatients [6,[10][11][12][13][14][15][16]. The most common CADR is morbilliform exanthema, followed by urticarial or fixed drug eruption [10][11][12][16][17][18][19][20]. SCARDs represent 0.13% to 16.5% [11,15,18,21,22].…”

“…SCARDs represent 0.13% to 16.5% [11,15,18,21,22]. The drugs most frequently involved are, in general, antibiotic agents, analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), contrast media, anticonvulsants, and chemotherapy [6,10,11,13,[16][17][18][19][20]22,23].…”