Pagani Silvia, Lombardi Niccolò, Crescioli Giada, Vighi Violetta Giuditta, Spada Giulia, Andreetta Paola, Capuano Annalisa, Vannacci Alfredo, Venegoni Mauro, Vighi Giuseppe Danilo
Department of Medicine, ASST Vimercate, 20871 Vimercate, Italy.
Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy.
J Clin Med. 2022 May 16;11(10):2811. doi: 10.3390/jcm11102811.
The aim of the present study is to describe pharmacological characteristics of drug-related allergies and anaphylaxis leading to the emergency department (ED). An 8-year post hoc analysis on the MEREAFaPS Study database was performed (2012−2019). Subjects who experienced drug-related hypersensitivity leading to an ED visit were selected. Logistic regression analyses were used to estimate the reporting odds ratios (RORs) of drug-related allergies and anaphylaxis adjusting for sex, age classes, and ethnicity. In addition, a systematic review of observational studies evaluating drug-related hypersensitivity reactions leading to ED visits in outpatients was performed. Out of 94,073 ED visits, 14.4% cases were drug-related allergies and 0.6% were anaphylaxis. Females accounted for 56%. Multivariate logistic regression showed a higher risk of drug-related allergy among males and all age classes < 65 years, while a higher risk of anaphylaxis was observed for females (ROR 1.20 [1.01−1.42]) and adults (ROR 2.63 [2.21−3.14]). The systematic review included 37 studies. ED visits related to allergy and anaphylaxis ranged from 0.004% to 88%, and drug-related allergies and anaphylaxis ranged from 0.007% to 88%. Both in our analysis and in primary studies, antibacterials, analgesics, and radiocontrast agents were identified as the most common triggers of hypersensitivity.
本研究的目的是描述导致急诊室（ED）就诊的药物相关过敏和过敏反应的药理学特征。对MEREAFaPS研究数据库进行了一项为期8年的事后分析（2012 - 2019年）。选择了因药物相关超敏反应导致急诊就诊的受试者。采用逻辑回归分析来估计药物相关过敏和过敏反应的报告比值比（ROR），并对性别、年龄组和种族进行了调整。此外，还对评估门诊患者因药物相关超敏反应导致急诊就诊的观察性研究进行了系统综述。在94,073次急诊就诊中，14.4%的病例为药物相关过敏，0.6%为过敏反应。女性占56%。多变量逻辑回归显示，男性和所有年龄小于65岁的人群中药物相关过敏的风险较高，而女性（ROR 1.20 [1.01 - 1.42]）和成年人（ROR 2.63 [2.21 - 3.14]）中过敏反应的风险较高。系统综述纳入了37项研究。与过敏和过敏反应相关的急诊就诊率从0.004%到88%不等，与药物相关的过敏和过敏反应率从0.007%到88%不等。在我们的分析和初步研究中，抗菌药物、镇痛药和放射性造影剂均被确定为最常见的超敏反应触发因素。
