AI Article Synopsis
- - The study aimed to evaluate the effectiveness of patch tests (PTs) in identifying drugs causing non-immediate cutaneous adverse drug reactions (NICADRs) by comparing readings at days 3 (D3) and 4 (D4).
- - Findings revealed that only 13.7% of patients tested positive on D3, while 24.9% tested positive on D4, highlighting a significant increase in sensitivity with the later reading (p < 0.0001).
- - The research concluded that an additional reading at D4 improves the detection of culprit drugs in NICADRs, suggesting further investigations to confirm these results and explore the cost-effectiveness of this testing approach.
Article Abstract
Background: Patch tests (PTs) are recommended to identify the culprit drug in non-immediate cutaneous adverse drug reactions (NICADRs). We recently reported that, in patients with NICADRs, a unique reading of PTs at day (D)2 compared with an additional second late reading at D4 missed almost half (45.3%) of the positive PTs.
Objectives: To assess the change in sensitivity of the PT reading on D4 compared with the reading on D3.
Methods: We performed a retrospective (July 2020-June 2023) monocentric study of patients who had PTs with two readings for a NICADR. We compared reading on D3 and the second reading on D4 for the suspected drug (primary outcome) and for the related drugs tested simultaneously (secondary outcome).
Results: During the study period, 249 patients underwent patch testing with D3 and D4 readings. Regarding the primary outcome, the first reading at D3 was positive for 13.7% of patients, and the reading at D4 for 24.9% of patients (p < 0.0001). Regarding the secondary outcome, only 9.6% of patients had all their positive PT at D3 compared with 24.9% of patients at D4 (p < 0.0001). Considering the evaluated drug classes, no statistical difference was observed. However, we highlight that D3 reading detected all positive carbamazepine PTs (n = 3) while positive clindamycin PTs (n = 4) were identified only with the help of the second reading on D4.
Conclusion: This study showed that, an additional D4 reading compared with a single D3 reading enhanced the sensitivity of PTs to identify culprit drugs and related. Further studies should replicate these findings and evaluate the medico-economic balance and safety of a single reading of PTs on D4.
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| http://dx.doi.org/10.1111/cod.14654 | DOI Listing |
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