Ten-year outcomes of Perioperative Anaphylaxis Workup Study in Hong Kong (PAWS-HK)

Au, Elaine; Mak, Hugo W.F.; Yeung, Maegan H.Y.; Chiang, Valerie; Lam, Ki; Wong, Jane C. Y.; Yeung, Heather H.F.; Chan, Eric Y.; Lau, Chak-Sing; Li, Philip H.

doi:10.1016/j.anai.2023.02.017

Cited by 4 publications

(1 citation statement)

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“…This made it impossible to exclude or confirm presence of PEG in all formulations of any of the top 50 reported drug allergy culprits in Hong Kong. This problem also pertains to all possible excipients including other commonly implicated culprits of drug-associated allergies such as carboxymethylcellulose (a polymer derived from cellulose commonly used in barium contrast or corticosteroid formulations), gelatin (hydrolysed form of collagen, commonly used in tablets/capsules or colloid fluids) and polysorbate 80 (a common excipient found in injectable medications) ( 3 , 12 , 13 ). Further studies into the prevalence and impact of other excipient allergies are warranted; nonetheless, this study illustrates the danger and inability to select safe formulations for excipient allergy patients in our region.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a drug allergy registry-based excipient allergy database and call for universal mandatory drug ingredient disclosure: the case of PEG

Kan,

Chiang,

Saha

et al. 2024

Front. Allergy

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BackgroundExcipient allergy is a rare, but potentially lethal, form of drug allergy. Diagnosing excipient allergy remains difficult in regions without mandatory drug ingredient disclosure and is a significant barrier to drug safety.ObjectiveTo investigate the feasibility of a drug allergy registry-based excipient database to identify potential excipient culprits in patients with history of drug allergy, using polyethylene glycol (PEG) as an example.MethodsAn excipient registry was created by compiling the excipient lists pertaining to all available formulations of the top 50 most reported drug allergy culprits in Hong Kong. Availability of excipient information, and its relationship with total number of formulations of individual drugs were analysed. All formulations were checked for the presence or absence of PEG.ResultsComplete excipient information was available for 36.5% (729/2,000) of all formulations of the top 50 reported drug allergy culprits in Hong Kong. The number of formulations for each drug was associated with proportion of available excipient information (ρ = 0.466, p = 0.001). Out of 729 formulations, 109 (15.0%) and 620 (85.0%) were confirmed to contain and not contain PEG, respectively. Excipient information was not available for the other 1,271 (63.6%) formulations. We were unable to confirm the presence or absence of PEG in any of the top 50 drug allergy culprits in Hong Kong.ConclusionIn countries without mandatory drug ingredient disclosure, excipient databases are unlikely able to identify potential excipient allergy in drug allergy patients. Legislations to enforce mandatory and universal ingredient disclosure are urgently needed.

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Section: Discussionmentioning

confidence: 99%