Report from the National Institute of Allergy and Infectious Diseases workshop on drug allergy

Abstract

Allergic reactions to drugs are a serious public health concern. In 2013, the National Institute of Allergy and Infectious Diseases, Division of Allergy, Immunology and Transplantation, sponsored a workshop on drug allergy. International experts in the field of drug allergy with backgrounds in allergy, immunology, infectious diseases, dermatology, clinical pharmacology and pharmacogenomics discussed the current state of drug allergy research. These experts were joined by representatives from several NIH Institutes and the U.S. Food and Drug Administration (FDA). The participants identified important advances that make new research directions feasible and made suggestions for research priorities and for development of infrastructure to advance our knowledge of the mechanisms, diagnosis, management, and prevention of drug allergy. The workshop summary and recommendations are presented herein.

Diagnosis and management of anaphylaxis in precision medicine

“…31 Efforts are currently underway to generate suitable skin test reagents and establish the predictive value of cephalosporin skin tests. 32…”

Risk stratification and skin testing to guide re-exposure in taxane-induced hypersensitivity reactions

“…[2][3][4] Although an immunologic mechanism has not been demonstrated, the term immediate hypersensitivity reaction (HSR) is used to designate adverse reactions with features suggestive of mast cell/basophil degranulation that occur during taxane infusions. [5][6][7] Taxanes are an integral part of the chemotherapeutic regimen used in gynecologic malignancies and are frequently administered in patients with various cancers, including breast, prostate, and lung cancers. 8,9 In early clinical trials paclitaxel and docetaxel caused a high rate of immediate HSRs, usually during first or second exposure.…”

Drug hypersensitivity: We need to do more

“…Thus DHR research is needed, as has been emphasized repeatedly. 1,2 Sullivan et al 3 used piperacillin as a model for b-lactam hypersensitivity. They studied the nature of the piperacillin-specific Tcell response isolated from blood and positive patch test results of hypersensitive patients and also included T-cell clones (TCCs) from healthy volunteers.…”