Casciaro Marco, Navarra Michele, Inferrera Giuseppina, Liotta Marta, Gangemi Sebastiano, Minciullo Paola Lucia
1School and Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
2Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.
Clin Mol Allergy. 2019 Jan 18;17:1. doi: 10.1186/s12948-019-0104-4. eCollection 2019.
Proton pump inhibitors (PPIs) are drugs capable of blocking the gastric pump H,K-ATPase in order to inhibit gastric acid secretion. Omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole belong to PPIs category. Although PPIs have a good safety profile, allergic reactions to these molecules can occur. The real rate of hypersensitive reactions to PPIs is unknown. The aim of this retrospective study is to evaluate the rate of hypersensitive reactions to PPIs in patients admitted to our Unit between 2008 and 2013 with a history of drug hypersensitivity. From a database of 1229 patients (921 women, 308 men) with adverse drug reaction we extrapolated the data about PPI reactions. Twelve patients (10 female, 2 men) had a positive history for hypersensitive reaction to PPI. Pantoprazole was the most frequently PPI involved. Based on patient personal history in some cases we performed an oral challenge test for an alternative anti-acid drug and none of them had adverse reactions. According to our experience and according to the literature and pharmacovigilance reports, ADR caused by PPIs are ever increasing. Adverse reactions to these drugs are still under-reported; however, considering the frequency of their prescription worldwide, the risk of severe allergic events is low. Further studies are needed to provide clearer data on the real incidence and prevalence about this matter. This should be useful to help physician in choosing the molecule to prescribe and, in case of hypersensitivity, the alternative molecule to test, also considering the possible cross-reactivity.
质子泵抑制剂（PPIs）是一类能够阻断胃质子泵H，K - ATP酶以抑制胃酸分泌的药物。奥美拉唑、兰索拉唑、泮托拉唑、雷贝拉唑和埃索美拉唑都属于质子泵抑制剂类别。尽管质子泵抑制剂具有良好的安全性，但仍可能发生对这些药物分子的过敏反应。对质子泵抑制剂过敏反应的实际发生率尚不清楚。这项回顾性研究的目的是评估2008年至2013年期间入住我们科室且有药物过敏史的患者中对质子泵抑制剂过敏反应的发生率。从1229例有药物不良反应的患者（921名女性，308名男性）数据库中，我们提取了有关质子泵抑制剂反应的数据。12例患者（10名女性，2名男性）有对质子泵抑制剂过敏反应的阳性病史。泮托拉唑是最常涉及的质子泵抑制剂。在某些情况下，根据患者个人病史，我们对一种替代抗酸药物进行了口服激发试验，且无一例出现不良反应。根据我们的经验以及文献和药物警戒报告，质子泵抑制剂引起的药物不良反应呈上升趋势。这些药物的不良反应仍报告不足；然而，考虑到其在全球的处方频率，严重过敏事件的风险较低。需要进一步研究以提供关于此事实际发病率和患病率的更清晰数据。这将有助于医生选择处方药物分子，以及在过敏情况下选择用于检测的替代分子，同时还要考虑可能的交叉反应性。
