Drug allergy and autoimmune diseases

Watanabe, Yûko; Yamaguchi, Yukie

doi:10.1016/j.alit.2022.02.001

Cited by 12 publications

(5 citation statements)

References 55 publications

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“…HCQ intolerance depended on the initial dose of HCQ, as previously reported (9). In general, patients with Sjögren syndrome tend to have drug allergies (16). However, autoantibodies against SS-A and SS-B were not associated with HCQ intolerance or cutaneous ADRs in this study.…”

Section: Discussionsupporting

confidence: 68%

Safe Introduction of Hydroxychloroquine Focusing on Early Intolerance Due to Adverse Drug Reactions in Patients with Systemic Lupus Erythematosus

et al. 2023

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Objective This study explored the predictors of hydroxychloroquine intolerance and propose appropriate methods to initiate hydroxychloroquine in patients with systemic lupus erythematosus. Methods This retrospective study registered consecutive patients who were diagnosed with systemic lupus erythematosus and started treatment with hydroxychloroquine between 2015 and 2021. Any adverse events that required dose reduction or cessation of hydroxychloroquine, indicating intolerance to the drug, were recorded for up to 26 weeks after initiation of hydroxychloroquine. Results A total of 130 patients were included. Hydroxychloroquine intolerance due to adverse drug reactions was observed in 28 patients (21.5%), including gastrointestinal symptoms in 15 (11.5%) and cutaneous reactions in 7 (5.4%). Furthermore, the intolerance was observed more frequently in the maintenance group (patients treated daily with <20 mg prednisolone) than in the induction group (7.1% vs. 25.5%, p=0.04), and none of the patients in the induction group developed cutaneous reactions. The initial dose of hydroxychloroquine per ideal body weight was associated with hydroxychloroquine intolerance in a dose-dependent manner. Multivariable analyses revealed that the hydroxychloroquine dose per ideal body weight and higher levels of C4 predicted hydroxychloroquine intolerance. In particular, C4 levels were positively correlated with cutaneous reactions, whereas the dose of prednisolone was negatively correlated with gastrointestinal reactions. Conclusion Low-dose hydroxychloroquine may be optimal for induction in patients with systemic lupus erythematosus who have high C4 levels or are taking low doses of steroids.

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Section: Discussionsupporting

confidence: 68%

Safe Introduction of Hydroxychloroquine Focusing on Early Intolerance Due to Adverse Drug Reactions in Patients with Systemic Lupus Erythematosus

et al. 2023

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“…In our study, we found that the presence of autoimmune diseases is a distinct risk factor for cephalosporin allergy, as shown as Table 3. Systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), Sjögren's syndrome, and scleroderma, have a high frequency of drug allergies [20]. T-cell activation and regulatory T cell dysfunction are associated with severe drug eruptions and autoimmune diseases, including SLE and SJS/TEN.…”

Section: Discussionmentioning

confidence: 99%

Association of HLA Alleles with Cephalosporin Allergy in the Taiwanese Population

Wang,

Shen,

Lin

et al. 2024

Preprint

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Background: Cephalosporin antibiotics are widely used in clinical settings, but they can cause hypersensitivity reactions, which may be influenced by genetic factors such as the expression of Human leukocyte antigen (HLA) molecules. This study aimed to investigate whether specific HLA alleles were associated with an increased risk of adverse reactions to cephalosporins among individuals in the Taiwanese population. Methods: This retrospective case-control study analyzed data from the Taiwan Precision Medicine Initiative (TPMI) on 27,933 individuals who received cephalosporin exposure and had HLA allele genotyping information available. Using logistic regression analyses, we examined the associations between HLA genotypes, comorbidities, allergy risk, and severity. Results: Among the study population, 278 individuals had cephalosporin allergy and 2,780 were in the control group. Our results indicated that certain HLA alleles, including B55:02 (OR = 1.76, 95% CI: 1.18-2.61, p=0.005), C01:02 (OR = 1.36, 95% CI: 1.05-1.77, p=0.018), and DQB106:09 (OR = 2.58, 95% CI: 1.62-4.12, p<0.001), were significantly associated with an increased risk of cephalosporin allergy reactions. Additionally, the HLA-C01:02 allele genotype was significantly associated with a higher risk of severe allergy (OR=2.33, 95% CI: 1.05-5.15, p=0.04). Conclusion: This study identified significant associations between HLA alleles and an increased risk of cephalosporin allergy, which can aid in early detection and prediction of adverse drug reactions to cephalosporins. Furthermore, our study highlights the importance of HLA typing in drug safety and expanding our knowledge of drug hypersensitivity syndromes.

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“…In autoimmune disease, disturbed regulatory immunity augments cytotoxic reactions, which are associated with the induction of SJS/TEN. 31 , 32 Diabetes often causes internal organ damage, such as that to the kidney and liver, leading to increased drug concentrations by impaired metabolizing activity, and this might be associated with the augmentation of hypersensitivity reactions. Peripheral vascular disease (eg, ICD-10 codes I70, I71, I731, I738, I739, I771, I790, I792, K551, K558, K559, Z958, and Z959) is an ambiguous category including intermittent claudication, peripheral angiopathy (not otherwise specified), and spasm of an artery.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and drugs that trigger the onset of Stevens–Johnson syndrome and toxic epidermal necrolysis: A population-based cohort study using the Shizuoka Kokuho database

Ubukata¹,

Nakatani²,

Hashizume

et al. 2023

JAAD International

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Drug allergy and autoimmune diseases

Cited by 12 publications

References 55 publications

Safe Introduction of Hydroxychloroquine Focusing on Early Intolerance Due to Adverse Drug Reactions in Patients with Systemic Lupus Erythematosus

Safe Introduction of Hydroxychloroquine Focusing on Early Intolerance Due to Adverse Drug Reactions in Patients with Systemic Lupus Erythematosus

Association of HLA Alleles with Cephalosporin Allergy in the Taiwanese Population

Risk factors and drugs that trigger the onset of Stevens–Johnson syndrome and toxic epidermal necrolysis: A population-based cohort study using the Shizuoka Kokuho database

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