Task Force on Desensitization

• Preliminary Questionnaire– In which clinical situations have desensitization

been performed– To which drugs?– Which protocol (reference/s)?– Total number of patients in each drug group– Total number of desensitizations (for each drug

group)– Outcomes / how they have been measured?– Simultaneous in vitro analysis have bee done?

Task Force on DesensitizationGul Karakaya

Dpt Chest Diseases – Adult Allergy Unit – Turkey

ASA/ 22 patients/ modified protocol (?)

Outcomes: Clinical scales, FEV1, QoLQ

Gulfem Celik

Dpt Allergy Ankara Medical School - Turkey

Atb (quinolones – protocol ?)

Going to start on ASA

Kvedariene Violeta (Lithuania) No (planning)

Joanna Makowska (Poland) No (planning)

Antonino Romano

Unità di Allergologia, Complesso Integrato Columbus - Italy

No (only in Polliclinico Gemely – Beta-lactams in CF – protocol ?)

Andreas Bircher

Allergologische Poliklinik - Switzerland

ASA/Beta-lactams (personnal protocol) and riphampicin (Int Arch Allergy Immunol 2006; 140:20-26)

Pascal Demoly

Hôpital Arnaud de Villeneuve - France

ASA - >50 pts (1/10/20/50 mg every 30 min)

CTZ - >100 pts (Demoly et al)

Others (insulin, TB drugs, anti-HIV drugs) – some as CTZ

Task Force on Desensitization

Drug Allergy Unit – Allergy and Clinical Immunology Division, Hospital São João and Oporto Faculty of Medicine, Portugal

ASA 100mg (prophylaxis for CD) 10 pts (modified protocol based in Stevenson et al)

ASA 500 mg (AERD – nasal polyposis) 5 pts (modified protocol based in Stevenson et al)

Cotrimoxazole (HIV+ patients) >50 pts (modified protocol based in Demoly et al. J Allergy Clin Immunol. 1998 Dec;102:1033-6)

Penicillin (pregnant women, atb resistance) 6 pts (based on Middleton’s Allergy: Principles and Practice 4th edition)

Allopurinol (gout) 3 pts (based in Allergy. 2003 Jul;58(7):690)

Levofloxacin (pts with bronchiectasis) 1 pt (based on oral penicillin desensitization protocol)

Carboplatin (optochiasmatic gliomas) 3 pts (based in Lee et al Gynecol Oncol. 2005 Nov;99(2):393-9)

Task Force on DesensitizationDrug Allergy Unit – Allergy and Clinical Immunology Division, Hospital São João

and Oporto Faculty of Medicine, Portugal

Insulin 2 pts ( based on Drug Allergy and Protocols for Management of Drug Allergies – 2nd Edition. Roy Patterson et al)

Riphampicin (HIV+ and TB infection) 3 pts (based on (Int Arch Allergy Immunol 2006; 140:20-26)

Isoniazid (systemic TB) 2 pts. Josefina Rodrigues et al, (The Internet Journal of Pharmacology. 2004. Volum 3 Number1)

L-asparaginase – E coli (Leukemia) 4 pts (based on J Allergy Clin Immunol 1998;101:571-572)

Anastrozole (Breast cancer) 2 pts - Personnal protocol (EAACI 2007)

Anti-thymocyte globulin (thymoglobulin) - leukemia

1 pt (based on J Allergy Clin Immunol 1998;101:571-572) - Failure

Methylphenidate (ADHS) 1 pt (based on J Child Adolesc Psychopharmacol. 2005;15:703-5) EAACI 2007

Sulfasalazin (IBD) 4 pts (based on Ann Allergy Asthma Immunol. 1999;83:23-4

Task Force on Desensitization

• Proposal– Register desensitization protocols in EXCEL

program• Main disease• Concomitant diseases• Drug • Initial dose• Route of administration• Interval• Cumulative dose• Continuous• Intermittent• Outcomes• Protocol reference(s)