Division of Pulmonary, Allergy, and Critical Care Medicine; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh Pennsylvania, United States.
Curr Drug Saf. 2021;16(1):97-100. doi: 10.2174/1574886315666201002153354.
Chronic spontaneous urticaria (CSU) is characterized by recurrent hives without a known trigger. While certain drugs are associated with urticaria exacerbations, the overall drug allergy incidence in CSU is unknown. We hypothesized that the incidence of drug allergy in CSU would be greater than the general population and that there would be distinguishing clinical features of drug-allergic CSU patients.
362 adult CSU patients seen over a 10-year period at a University Allergy/Asthma clinic were identified. Patients reported no drug allergies or any drug allergy. Multiple drug allergies were defined as allergies to ≥ 2 chemically unrelated drugs. Using Chi-square or Wilcoxon analysis, we compared demographic features of CSU with and without drug allergy and with multiple vs. single drug allergy.
Overall, 202 CSU patients (56%) reported drug allergy. Drug allergic CSU patients were older, with a greater proportion of whites and higher BMI vs. CSU without drug allergy (p=0.002, p=0.047, p=0.004, respectively). Penicillin was the most common drug allergy, with urticaria the most frequently reported reaction. Female sex, white race, older age at the visit, and co-existing asthma were more common in multiple drug allergy (n=115) vs. single drug allergy (p=0.002, p=0.02, p=0.03, p=0.0002, respectively).
In CSU, the prevalence of self-reported drug allergies was higher than the general population. Drug allergy is associated with older age, white race and higher BMI, while multiple drug allergy was also associated with asthma. These CSU sub-populations should be studied to avoid the potential for morbidity associated with less efficacious and more costly drugs.
慢性自发性荨麻疹（CSU）的特征是反复出现荨麻疹，且无已知诱因。虽然某些药物与荨麻疹恶化有关，但 CSU 中总体药物过敏发生率尚不清楚。我们假设 CSU 中的药物过敏发生率会高于一般人群，并且药物过敏性 CSU 患者会有一些独特的临床特征。
在一家大学过敏/哮喘诊所的 10 年期间，我们确定了 362 名成年 CSU 患者。患者报告无药物过敏或任何药物过敏。多种药物过敏定义为对≥2 种化学上无关的药物过敏。使用卡方检验或 Wilcoxon 分析，我们比较了有和无药物过敏的 CSU 患者以及多种和单一药物过敏患者的人口统计学特征。
总体而言，202 名 CSU 患者（56%）报告有药物过敏。药物过敏性 CSU 患者年龄较大，白种人比例较高，BMI 也较高，与无药物过敏的 CSU 患者相比（p=0.002，p=0.047，p=0.004）。青霉素是最常见的药物过敏，荨麻疹是最常见的过敏反应。女性、白种人、就诊时年龄较大以及并存哮喘在多种药物过敏（n=115）中比单一药物过敏（p=0.002，p=0.02，p=0.03，p=0.0002）中更为常见。
在 CSU 中，自我报告的药物过敏发生率高于一般人群。药物过敏与年龄较大、白种人以及较高的 BMI 相关，而多种药物过敏还与哮喘有关。这些 CSU 亚人群应进行研究，以避免因使用疗效较差且成本更高的药物而导致潜在的发病率。
