Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier.
Desbrest Institute of Epidemiology and Public Health, University of Montpellier - INSERM - Inria (Premedical).
Curr Opin Allergy Clin Immunol. 2024 Aug 1;24(4):203-209. doi: 10.1097/ACI.0000000000001003. Epub 2024 Jun 14.
To understand the current global scale of drug hypersensitivity (DH) and drug allergy (DA), and to identify possible strategies to increase the accuracy of epidemiological data.
Global patterns of DH/DA seem to be changing and increasing worldwide, but there are still great challenges in capturing quality DH/DA mortality and morbidity statistics (MMS). DH/DA MMS may gain new perspectives with the global implementation of the International Classification of Diseases (ICD)-11. Improving the quality of epidemiological data related to DH/DA should clarify areas of uncertainty, which would lead to better strategies to reduce the burden of these conditions.
DH/DA remains a complex and unaddressed problem globally that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. DH/DA labels should contribute to people well being, by protecting true allergic individuals from being re-exposed to their allergic drugs and providing needed medications to individuals wrongly labeled as allergic or who have lost allergic sensitivity. The true rate of DH/DA is in fact unknown due to a number of factors, such as misdiagnosis, miscoding and under- and over-notification, among others. Moreover, there is lack of data about DH/DA epidemiology in many countries. Difficulties on collecting accurate and comparable data should be acknowledged, with great impact in the correct labeling DH/DA in electronic health records and official statistics. More accurate definitions, classification and coding may contribute to a better-quality MMS thanks to the ICD-11, under implementation worldwide. Improving the quality of epidemiological data related to DH/DA should clarify areas of uncertainty, which would lead to better strategies to reduce the burden of these conditions. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to DH/DA in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.
了解当前全球药物超敏反应(DH)和药物过敏(DA)的规模,并确定提高流行病学数据准确性的可能策略。
全球范围内的 DH/DA 模式似乎在发生变化并在全球范围内不断增加,但在捕捉高质量的 DH/DA 死亡率和发病率统计数据(MMS)方面仍然存在巨大挑战。随着 ICD-11 在全球范围内的实施,DH/DA MMS 可能会获得新的视角。提高与 DH/DA 相关的流行病学数据质量应能澄清不确定领域,从而制定出更好的策略来减轻这些疾病的负担。
DH/DA 仍然是一个在全球范围内复杂且未得到解决的问题,它常常使患者无法选择最佳药物,并使他们面临危及生命的反应的风险。DH/DA 标签应通过保护真正过敏的个体免受再次接触其过敏药物,并为被错误标记为过敏或已失去过敏敏感性的个体提供所需药物,从而为人们的健康做出贡献。由于多种因素,如误诊、误码和漏报和不报等,实际上并不知道 DH/DA 的真实发生率。此外,许多国家缺乏关于 DH/DA 流行病学的数据。在收集准确和可比数据方面存在困难,这对电子健康记录和官方统计中的正确标记 DH/DA 有很大影响。更准确的定义、分类和编码可能会由于 ICD-11 的实施而有助于提高 MMS 的质量。提高与 DH/DA 相关的流行病学数据质量应能澄清不确定领域,从而制定出更好的策略来减轻这些疾病的负担。由于从人群中获得的知识是更现实决策的关键信息,因此 ICD-11 中针对 DH/DA 的新部分的构建将允许收集更准确的流行病学数据,以支持患者的质量管理,并促进医疗保健规划以实施公共卫生措施,以预防和减少这些疾病的发病率和死亡率。