Mesalamine desensitization in a patient with treatment refractory ulcerative colitis and aspirin and nonsteroidal anti-inflammatory drug hypersensitivity

Heath, Jordan; Heath, Ryan D.; Tamboli, Cyrus; Johnson, Larry E.; Wilson, Ashley S.; Chervinskiy, Sheva K.; Bell, Matthew C.; Kennedy, Joshua L.

doi:10.1016/j.anai.2017.01.026

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…Furthermore, caution should be exercised when prescribing mesalazine to patients who have a history of hypersensitivity reaction to aspirin, as the similarities in their chemical structure and function (both serve to inhibit cyclooxygenase enzymes) can lead to cross‐reactivity between the two compounds, further contributing to hypersensitivity. Such patients may need to undergo mesalazine desensitisation protocols …”

Section: Resultsmentioning

confidence: 99%

“…It is thought to have a beneficial anti‐inflammatory action via increased expression of peroxisome proliferator‐activated receptors in gastrointestinal epithelial cells . Furthermore, it acts to inhibit COX enzymes, thus affecting prostaglandins and decreasing inflammation of the colon . Therapy is expected to improve symptoms within 2‐4 weeks of initiation .…”

Section: Introductionmentioning

confidence: 99%

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Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

121

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Patients on mesalazine should be monitored for worsening of ulcerative colitis and development of new onset organ dysfunction. High-dose mesalazine appears to have similar safety profile as low dose, and is not associated with greater risk of adverse events. Prior to placing a patient on mesalazine, baseline liver and renal function should be evaluated. Renal function should be periodically assessed, whereas other testing should be performed depending on development of symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

121

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“…21 Desensitization is generally performed during hospitalization by starting 5-ASA at a small dosage and gradually increasing the dose. 22,23 This treatment method is begun while the patient is still in the hospital because it enables prevention of emergency hospitalization and provision of adequate care for unexpected serious adverse events; furthermore, the effectiveness of desensitization remains controversial. 24 In the present study, we aimed to begin the development of alternative therapeutic strategies for 5-ASA continuation in 5-ASA-intolerant patients.…”

Section: Discussionmentioning

confidence: 99%

5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis

et al. 2020

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clinical outcomes of UC have been improved by recently developed therapeutic drugs, 2,3 leading to reduced rates of surgical treatment and higher rates of clinical remission compared with previous conventional therapies. 4,5 However, many of these newly developed therapeutic agents still have limited effectiveness, variable responses, potential adverse events caused by immunosuppression, and pharmacoeconomic issues. 6 5-Aminosalicylic acid (ASA) consists of salazosulfapyridine and mesalazine. It is the first-line drug in induction therapy for mild to moderately active UC and in maintenance therapy for

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“…In general, desensitization has been shown to be useful to maintain the first election treatment in multiple groups of drugs, including anticonvulsants, antituberculosis medication, antibiotics, NSAIDs and others, in both IR and NIR, and even in paediatric population and patients with multiple autoimmune disorders …”

Section: Novel Tools For Managing Dhrmentioning

confidence: 99%

“…184 Moreover, long premedication protocols increase costs, side effects and length of hospital stay. 185 In general, desensitization has been shown to be useful to maintain the first election treatment in multiple groups of drugs, 67 including anticonvulsants, 13 antituberculosis medication, 186,187 antibiotics, [188][189][190] NSAIDs 96,183,191,192 and others, 193,194 in both IR 96,174,178,188,191,194 and NIR, 96,186,187,190,193 and even in paediatric population 86,188,192 and patients with multiple autoimmune disorders. 189…”

Section: Novel Tool S For Manag Ing Dhrmentioning

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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Mesalamine desensitization in a patient with treatment refractory ulcerative colitis and aspirin and nonsteroidal anti-inflammatory drug hypersensitivity

Cited by 11 publications

References 6 publications

Systematic review: safety of mesalazine in ulcerative colitis

Systematic review: safety of mesalazine in ulcerative colitis

5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis

Recent developments and highlights in drug hypersensitivity

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