Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Standards for practical intravenous rapid drug desensitization & delabeling : A WAO committee statement. / Steering Committee Authors; Review Panel Members.
I: World Allergy Organization Journal, Bind 15, Nr. 6, 100640, 06.2022.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Standards for practical intravenous rapid drug desensitization & delabeling
T2 - A WAO committee statement
AU - Madrigal-Burgaleta, Ricardo
AU - Alvarez-Cuesta, Emilio
AU - Broyles, Ana D.
AU - Cuesta-Herranz, Javier
AU - Guzman-Melendez, Maria Antonieta
AU - Maciag, Michelle C.
AU - Phillips, Elizabeth J.
AU - Trubiano, Jason A.
AU - Wong, Johnson T.
AU - Ansotegui, Ignacio
AU - Ali, F. Runa
AU - Angel-Pereira, Denisse
AU - Banerji, Aleena
AU - Berges-Gimeno, Maria Pilar
AU - Bernal-Rubio, Lorena
AU - Brockow, Knut
AU - Cardona Villa, Ricardo
AU - Castells, Mariana C.
AU - Caubet, Jean Christoph
AU - Chang, Yoon Seok
AU - Ensina, Luis Felipe
AU - Chikhladze, Manana
AU - Chiriac, Anca Mirela
AU - Chung, Weng Hung
AU - Ebisawa, Motohiro
AU - Fernandes, Bryan
AU - Garvey, Lene Heise
AU - Gomez, Maximiliano
AU - Gomez Vera, Javier
AU - Gonzalez Diaz, Sandra
AU - Hong, David I.
AU - Ivancevich, Juan Carlos
AU - Kang, Hye Ryun
AU - Khan, David A.
AU - Kuruvilla, Merin
AU - Larco Sousa, Jose Ignacio
AU - Latour-Staffeld, Patricia
AU - Liu, Anne Y.
AU - Macy, Eric
AU - Malling, Hans Jorgen
AU - Maspero, Jorge
AU - May, Sara M.
AU - Mayorga, Cristobalina
AU - Park, Miguel A.
AU - Peter, Jonathan
AU - Picard, Matthieu
AU - Rodriguez-Bouza, Tito
AU - Romano, Antonino
AU - Tanno, Luciana Kase
AU - Torres, Maria Jose
AU - Steering Committee Authors
AU - Review Panel Members
N1 - Publisher Copyright: © 2022 The Authors
PY - 2022/6
Y1 - 2022/6
N2 - Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be suspended. Even if virtually any intravenous medication can potentially trigger a life-threatening DHR, chemotherapeutics, biologics, and antibiotics are amongst the intravenous drugs most frequently involved in these reactions. Admittedly, suspending such treatments may negatively impact the survival outcomes or the quality of life of affected patients. Delabeling pathways and rapid drug desensitization (RDD) can help reactive patients stay on first-choice therapies instead of turning to less efficacious, less cost-effective, or more toxic alternatives. However, these are high-complexity and high-risk techniques, which usually need expert teams and allergy-specific techniques (skin testing, in vitro testing, drug provocation testing) to ensure safety, an accurate diagnosis, and personalized management. Unfortunately, there are significant inequalities within and among countries in access to allergy departments with the necessary expertise and resources to offer these techniques and tackle these DHRs optimally. The main objective of this consensus document is to create a great benefit for patients worldwide by aiding allergists to expand the scope of their practice and support them with evidence, data, and experience from leading groups from around the globe. This statement of the Drug Hypersensitivity Committee of the World Allergy Organization (WAO) aims to be a comprehensive practical guide on the technical aspects of implementing acute-onset intravenous hypersensitivity delabeling and RDD for a wide range of drugs. Thus, the manuscript does not only focus on clinical pathways. Instead, it also provides guidance on topics usually left unaddressed, namely, internal validation, continuous quality improvement, creating a healthy multidisciplinary environment, and redesigning care (including a specific supplemental section on a real-life example of how to design a dedicated space that can combine basic and complex diagnostic and therapeutic techniques in allergy).
AB - Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be suspended. Even if virtually any intravenous medication can potentially trigger a life-threatening DHR, chemotherapeutics, biologics, and antibiotics are amongst the intravenous drugs most frequently involved in these reactions. Admittedly, suspending such treatments may negatively impact the survival outcomes or the quality of life of affected patients. Delabeling pathways and rapid drug desensitization (RDD) can help reactive patients stay on first-choice therapies instead of turning to less efficacious, less cost-effective, or more toxic alternatives. However, these are high-complexity and high-risk techniques, which usually need expert teams and allergy-specific techniques (skin testing, in vitro testing, drug provocation testing) to ensure safety, an accurate diagnosis, and personalized management. Unfortunately, there are significant inequalities within and among countries in access to allergy departments with the necessary expertise and resources to offer these techniques and tackle these DHRs optimally. The main objective of this consensus document is to create a great benefit for patients worldwide by aiding allergists to expand the scope of their practice and support them with evidence, data, and experience from leading groups from around the globe. This statement of the Drug Hypersensitivity Committee of the World Allergy Organization (WAO) aims to be a comprehensive practical guide on the technical aspects of implementing acute-onset intravenous hypersensitivity delabeling and RDD for a wide range of drugs. Thus, the manuscript does not only focus on clinical pathways. Instead, it also provides guidance on topics usually left unaddressed, namely, internal validation, continuous quality improvement, creating a healthy multidisciplinary environment, and redesigning care (including a specific supplemental section on a real-life example of how to design a dedicated space that can combine basic and complex diagnostic and therapeutic techniques in allergy).
KW - Antibiotic desensitization
KW - Antibiotics
KW - Betalactams
KW - Biological agents
KW - Chemotherapy
KW - Delabeling
KW - Drug allergy
KW - Drug challenge
KW - Drug desensitization
KW - Drug provocation test
KW - Penicillins
KW - Personalized medicine
KW - Precision medicine
KW - Risk stratification
KW - Skin test
U2 - 10.1016/j.waojou.2022.100640
DO - 10.1016/j.waojou.2022.100640
M3 - Review
C2 - 35694005
AN - SCOPUS:85134599289
VL - 15
JO - The World Allergy Organization Journal
JF - The World Allergy Organization Journal
SN - 1939-4551
IS - 6
M1 - 100640
ER -
ID: 327941684