Role of Skin Tests in the Diagnosis of Immediate Hypersensitivity Reactions to Taxanes: Results of a Multicenter Study

Pagani, Mauro; Bavbek, Sevim; Dursun, Adile Berna; Bonadonna, Patrizia; Caralli, María Elisa; Cernadas, Josefina; Cortellini, Gabriele; Costantino, Maria Teresa; Gelincik, Aslı; Lucchini, Giuseppe; Castells, Mariana

doi:10.1016/j.jaip.2018.09.018

Cited by 44 publications

(71 citation statements)

References 27 publications

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“…82 STs for taxanes (paclitaxel and docetaxel) showed a significant correlation with severe reactions although with low sensitivity (17%). 83 In children, STs have not shown clinical value in IR and NIR to amoxicillin. 84 However, in a retrospective study, STs have demonstrated a PPV of 99.4%, indicating their usefulness, before DPT.…”

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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Section: In Vivo Testsmentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Mayorga

Fernandez

Montañez

et al. 2019

Allergy

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“…Only a few series about DPT in regard to antineoplastic and biological agents (BA) have been reported [196][197][198][199][200][201][202][203].…”

Section: Biological and Cytostatic Drugsmentioning

confidence: 99%

“…Recently, Pagani et al reported a multicentric study that enrolled 84 patients with IR due to taxanes [203]. Sixteen patients without any alternative treatment, negative skin tests and mild reactions that involved the skin or a single organ (usually back pain), underwent graded challenges successfully.…”

Section: Biological and Cytostatic Drugsmentioning

confidence: 99%

“…Sixteen patients without any alternative treatment, negative skin tests and mild reactions that involved the skin or a single organ (usually back pain), underwent graded challenges successfully. The offending drug was administered at 10 mL/h for the first hour and if tolerated, the rest of the drug was administered according to the manufacturer's instructions [203].…”

Section: Biological and Cytostatic Drugsmentioning

confidence: 99%

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Spanish Society of Allergology and Clinical Immunology (SEAIC) Vision of Drug Provocation Tests

Audicana

Ortega

Lobera

et al. 2021

J Investig Allergol Clin Immunol

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The controlled drug exposure test (DPT) is currently considered the gold standard for the diagnosis of drug allergy. Drug-induced adverse reactions (ADRs) are a growing reason for consultation in both primary and specialized care. Allergology consultations in Spain are the ones that usually study these ADRs and rule out immunological mechanisms involved in up to 90% of the cases consulted. An adequate approach to these cases has an obvious impact on the costs and efficacy of the treatments required by other specialists, so that if we did not use DPTs, patients would require more expensive, more toxic and less effective treatments in most of the cases. In recent years, a large number of new drugs have been developed and this document is intended to be a practical guide in the management of PDT with the vision of the Spanish Allergology Society. Diagnostic work begins with a detailed history of the patient. Skin tests are only useful for some medications, and in most cases the diagnosis can only be confirmed by DPT. Although there is usually cross-reactivity, DPTs can confirm the diagnosis and also help to find a tolerable alternative drug. The individual management of patients in a programmed way, taking into account both the type of drug to be studied and the patient's comorbidities, usually allows a solution to be found for the majority of patients.

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“…Excessive tearing (epiphora) is a common side effect, reported in 64%–86% of patients with cancer receiving docetaxel-based therapy 1 2. Notably, severe hypersensitivity reactions have been described in response to docetaxel that have resulted in cessation of treatment and the development of desensitisation protocols 3 4. However, taxane use is not known to be associated with periorbital rash.…”

Section: Introductionmentioning

confidence: 99%

Periorbital dermatitis in patients receiving docetaxel in combination chemotherapy

Tabata¹,

Kwong

2019

BMJ Case Rep

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Recognition of new cutaneous side effects of combination chemotherapy can help prevent unnecessary cessation or reduction of cancer therapy. Periorbital rash has not been found with docetaxel alone, but here, we report it as a result of combination chemotherapy. A series of three patients who received docetaxel in combination with other chemotherapies developed clinically near-identical, distinctive periorbital rashes. Rashes resolved by resolving underlying docetaxel-induced epiphora in conjunction with ophthalmological consultation, topical skin-directed care, and in some cases, chemotherapy dose reduction. It is important for dermatologists and oncologists to recognise the increased severity of cutaneous reactions when docetaxel is used in combination chemotherapy.

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Role of Skin Tests in the Diagnosis of Immediate Hypersensitivity Reactions to Taxanes: Results of a Multicenter Study

Cited by 44 publications

References 27 publications

Recent developments and highlights in drug hypersensitivity

Recent developments and highlights in drug hypersensitivity

Spanish Society of Allergology and Clinical Immunology (SEAIC) Vision of Drug Provocation Tests

Periorbital dermatitis in patients receiving docetaxel in combination chemotherapy

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