Drug Provocation Test (DPT) to Paracetamol

University Hospital, Montpellier498 enrolled

Overview

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).

Study Type

OBSERVATIONAL

Enrollment

498

Conditions

Drug Hypersensitivity

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion criteria: \- Patients with a positive or negative DPT to paracetamol Exclusion criteria: * Patients refusing to take part in the study * Patient under 10 years old

Locations (1)

University hospital of Montpellier

Montpellier, Montpellier, France

Outcomes

Primary Outcomes

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.

Time frame: 1 day

Secondary Outcomes

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.

Time frame: 1 day