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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 Desensitization
Gul 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 – Betalactams 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 Desensitization
Drug 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
program
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Main disease
Concomitant diseases
Drug
Initial dose
Route of administration
Interval
Cumulative dose
Continuous
Intermittent
Outcomes
Protocol reference(s)
EXCEL