Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents

Ana M. Copaescu MD, FRCP , Hugo W.F. Mak MBBS , Sara Vogrin MBiostat , Natasha E. Holmes PhD , Jason A. Trubiano PhD , Philip H. Li MD
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Abstract

Background

Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown.

Objective

We sought to investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among patients in an international multicenter, multiethnic cohort.

Methods

HR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labeled with penicillin allergy, before their allergy evaluation, from 8 adult allergy/immunology clinics across Asia, Australia, and North America.

Results

We recruited 643 patients labeled with penicillin allergy (median age, 56 years [interquartile range, 39-67]; male:female ratio, 1:2.2), with 273 (42.5%), 186 (28.9%), and 184 (28.6%) from Asia, North America, and Australia, respectively. The median DrHy-Q score was 8.3 (interquartile range, 0.0-29.2). All patients underwent penicillin allergy evaluation, and 96% (617 of 643) were delabeled following negative provocation test results. Female patients (8.3 vs 4.2; P = .003), those with other concomitant antimicrobial allergy labels (20.8 vs 4.2; P = .004), and patients from Asia (33.3 vs 4.2 [North America] vs 0 [Australia]; P < .001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity as well as other allergy variables were not significant in the multivariate analysis.

Conclusions

Regional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labeled with penicillin allergy. Future studies are needed to understand the contributions of regional sociodemographic factors and identify interventions to improve HR-QoL.
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影响药物过敏生活质量的全球差异和风险因素:横跨三大洲的多中心、多种族药物过敏研究
背景青霉素过敏标签与许多不良后果有关。对未来用药的恐惧和限制也会对健康相关生活质量(HR-QoL)产生影响。我们试图调查青霉素过敏标签的影响,并比较国际多中心、多种族队列中患者的 HR-QoL 损害相关因素。方法 使用 6 项药物过敏性生活质量问卷(DrHy-Q)对亚洲、澳大利亚和北美的 8 家成人过敏/免疫诊所的青霉素过敏患者在进行过敏评估前的 HR-QoL 进行测量和比较。结果我们招募了 643 名青霉素过敏患者(中位年龄 56 岁[四分位数间距 39-67];男女比例 1:2.2),其中 273 人(42.5%)、186 人(28.9%)和 184 人(28.6%)分别来自亚洲、北美和澳大利亚。DrHy-Q评分的中位数为8.3(四分位距为0.0-29.2)。所有患者都接受了青霉素过敏评估,96% 的患者(643 人中有 617 人)在激发试验结果呈阴性后被除名。女性患者(8.3 vs 4.2; P = .003)、同时患有其他抗菌素过敏标签的患者(20.8 vs 4.2; P = .004)和亚洲患者(33.3 vs 4.2 [北美] vs 0 [澳大利亚]; P <.001)的 DrHy-Q 评分明显较高,反映出其 HR-QoL 有所降低。结论地区差异、种族和其他风险因素会影响青霉素过敏患者的 HR-QoL 损伤。未来的研究需要了解地区社会人口因素的贡献,并确定改善心率-QoL的干预措施。
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来源期刊
The journal of allergy and clinical immunology. Global
The journal of allergy and clinical immunology. Global Immunology, Allergology and Rheumatology
CiteScore
0.70
自引率
0.00%
发文量
0
审稿时长
92 days
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