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Background : Paracetamol (acetaminophen) drug hypersensitivity reactions (DHR) are oonfirmed in about 10% of alleged cases. The diagnosis is made via an empirical drug provocation test (DPT).
Objective: Detect eliciting dose thresholds during Paracetamol DPT in order to suggest optimal step doses and to identify variables and potential risk factors associated with Paracetamol hypersensitivity.
Methods:This retrospective study, using the survival analysis and the multivariate analysis, will comprise all patients who attended the allergy service of the University Hospital of Montpellier from 1996 till 2018 with a clinical history related to Paracetamol DHR, who underwent Paracetamol DPT and who gave their consent to be included in the study. The patients are selected from the Drug Allergy & Hypersensitivity Database (DAHD).
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| Measure | Description | Time Frame |
|---|---|---|
| Detect of the reactive dose (RD) | The outcome measure of the RD : The dose that the patient reaches when the DPT is positive, divided by the total DPT dose for a given patient. This RD will be calculated for every patient with a positive DPT. New events (positive DPT) from one RD to another will be evaluated in number and severity. | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Measure is a positive DPT to paracetamol | Identifying clinical risk factors (Odds Ratio), using the binary logistic regression method, significantly associated with a positive Paracetamol DPT. Age at reaction, sex, presence of asthma and atopy, type and chronology of the initial reaction will be evaluated as potential risk factors. Risk factors of anaphylaxis during DPT will also be calculated, using the same variables. Potential variables to explain this measure will be introduced in a logistic model, in order to obtain crude and adjusted OR that could explain a positive DPT to paracetamol. |
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Inclusion criteria:
- Patients with a positive or negative DPT to paracetamol
Exclusion criteria:
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Patient consulting in our allergy unit for a suspicion of drug hypersensitivity to Paracetamol and who underwent DPT.
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| Name | Affiliation | Role |
|---|---|---|
| Pascal DEMOLY, MD, PhD | University Hospital, Montpellier | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University hospital of Montpellier | Montpellier | Montpellier | 34295 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39038539 | Result | Ghiordanescu IM, Ciocanea-Teodorescu I, Molinari N, Jelen A, Al-Ali O, Schrijvers R, Demoly P, Chiriac AM. Comparative Performance of 4 Penicillin-Allergy Prediction Strategies in a Large Cohort. J Allergy Clin Immunol Pract. 2024 Nov;12(11):2985-2993. doi: 10.1016/j.jaip.2024.07.012. Epub 2024 Jul 20. |
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| ID | Term |
|---|---|
| D004342 | Drug Hypersensitivity |
| ID | Term |
|---|---|
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| D064419 | Chemically-Induced Disorders |
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| 1 day |