DRESS characteristics according to the causative medication

Background To date, no study has identified a clear relationship between drug and a specific clinical presentation of DRESS. Objectives To investigate the particularities of DRESS and analyze the variation of DRESS pattern according to culprit drugs. Methods We analyzed cases of DRESS notified to th...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2022-09, Vol.78 (9), p.1503-1510
Main Authors: Chaabane, A., Romdhane, H. Ben, Fadhel, N. Ben, Fredj, N. Ben, Ammar, H., Boughattas, N., Chadly, Z., Aouam, K.
Format: Article
Language:English
Subjects:
Allopurinol
Antibiotics
Anticonvulsants
Biomedical and Life Sciences
Biomedicine
Eosinophilia
Kidneys
Latency
Lymphadenopathy
Multivariate analysis
Pharmacoepidemiology and Prescription
Pharmacology/Toxicology
Skin tests
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Summary:Background To date, no study has identified a clear relationship between drug and a specific clinical presentation of DRESS. Objectives To investigate the particularities of DRESS and analyze the variation of DRESS pattern according to culprit drugs. Methods We analyzed cases of DRESS notified to the Department of Clinical Pharmacology at the University Hospital of Monastir over a 15-year period. The statistical study was performed using the comparative and multivariate analysis. Results DRESS was mostly induced by anticonvulsive agents (27%) followed by allopurinol (26.3%) and antibiotics (24%): For anticonvulsive agents, the occurrence of lymphadenopathy was higher, renal involvement was rare and mild, and positive skin tests were more frequent. The allopurinol group was associated with the patient’s older age and a lower incidence of lymphadenopathy and kidney injury. For antibiotics, eosinophilia rate was lower, time to recovery was shorter, and RegiSCAR score was low. The multivariate analysis showed a link of allopurinol with severe renal impairment, antibiotics with short latency period and low RegiSCAR score, and anticonvulsants with high propensity of positive skin test. Conclusion We report the largest African and south Mediterranean cohort of DRESS and evaluated the usefulness of skin tests in identifying the culprit drug. The prominent finding was that latency period and renal involvement may independently differ according to culprit drugs.
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-022-03353-8