Global differences and risk factors influencing drug hypersensitivity quality of life: A multicenter, multiethnic study of drug allergy across 3 continents
Authors:
- Copaescu, Ana M.
- Mak, Hugo W.F.
- Vogrin, Sara
- Holmes, Natasha E.
- Trubiano, Jason A.
- Li, Philip H.
Details:
Journal of Allergy and Clinical Immunology: Global, Volume 4, Issue 1, 2025-02-28
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Background Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown. Objective We sought to investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among patients in an international multicenter, multiethnic cohort. Methods HR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labeled with penicillin allergy, before their allergy evaluation, from 8 adult allergy/immunology clinics across Asia, Australia, and North America. Results We recruited 643 patients labeled with penicillin allergy (median age, 56 years [interquartile range, 39-67]; male:female ratio, 1:2.2), with 273 (42.5%), 186 (28.9%), and 184 (28.6%) from Asia, North America, and Australia, respectively. The median DrHy-Q score was 8.3 (interquartile range, 0.0-29.2). All patients underwent penicillin allergy evaluation, and 96% (617 of 643) were delabeled following negative provocation test results. Female patients (8.3 vs 4.2; P = .003), those with other concomitant antimicrobial allergy labels (20.8 vs 4.2; P = .004), and patients from Asia (33.3 vs 4.2 [North America] vs 0 [Australia]; P < .001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity as well as other allergy variables were not significant in the multivariate analysis. Conclusions Regional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labeled with penicillin allergy. Future studies are needed to understand the contributions of regional sociodemographic factors and identify interventions to improve HR-QoL.