The Psychological Relieving Effect of Drug Provocation Test in Drug Hypersensitivity

Figures & data

Table 1 Demographic and Clinical Characteristics of the Study Participants

Characteristics	Total (n=46)	Anaphylaxis (n=24)	Non-Anaphylaxis (n=22)	P
Female	25 (54.3)	11 (45.8)	14 (63.6)	0.226
Age*, years (18–84)	46.76 ± 12.57	49.92 ± 11.48	43.32 ± 13.05	0.075
Psychiatric disorder	2 (4.3)	1 (4.2)	1 (4.5)	0.950
Diabetes	5 (10.7)	1 (4.2)	4 (18.2)	0.127
Hypertension	10 (21.7)	6 (25.0)	4 (18.2)	0.575
Bronchial asthma	4 (8.7)	1 (4.2)	3 (13.6)	0.255
Allergic rhinitis	12 (26.1)	3 (12.5)	9 (40.9)	0.028
Atopic dermatitis	1 (2.2)	0 (0.0)	1 (4.5)	0.291
Chronic urticaria	2 (4.3)	2 (8.3)	0 (0.0)	0.166
Food allergy	7 (15.2)	2 (8.3)	5 (22.7)	0.175
Serum cortisol*, µg/dL	10.54 ± 6.32	10.38 ± 5.00	10.93 ± 7.88	0.790
Time interval between hypersensitivity reaction and DPT*, months (1–240)	18.15 ± 46.53	12.54 ± 48.52	24.27 ± 44.55	0.399
Culprit drugs
Antibiotics	19 (41.3)	15 (62.5)	4 (18.2)	0.002
NSAIDs	26 (56.5)	10 (41.7)	16 (72.7)	0.034
H2-blocker	4 (8.7)	2 (8.3)	2 (9.1)	0.927
Muscle-relaxant	3 (6.5)	3 (12.5)	0 (0.0)	0.086
Other drugs	12 (26.1)	3 (12.5)	9 (40.9)	0.028
Purpose of DPT
Identifying a culprit drug	15 (32.6)	5 (20.8)	10 (45.5)	0.075
Exclusion of a suspected drug	24 (52.2)	12 (50.0)	12 (54.5)	0.758
Confirming safe alternatives	46 (100.0)	24 (100.0)	22 (100.0)

Note: *Data are presented as mean ± SD.

Abbreviations: DPT, drug provocation test; NSAID, non-steroidal anti-inflammatory drug.

Figure 1 Comparison of the BAI (A) and BDI-II (B) scores before and after DPT in the study participants.

Abbreviations: BAI, Beck Anxiety Inventory; BDI-II, Beck Depression Inventory-II; DPT, drug provocation test.

Figure 2 Comparison of the BAI and BDI-II scores before and after DPTs between in the confirmed drug hypersensitivity group and in the suspected drug hypersensitivity group.

Figure 3 Comparison of the BAI and BDI-II scores before and after DPTs according to confirmation of drug hypersensitivity by DPT or not. The BAI (A) and BDI-II (B) scores before and after DPT in the confirmed drug hypersensitivity group (blue lines) (n=20). The BAI (C) and BDI-II (D) scores before and after DPT in the suspected drug hypersensitivity group (orange lines) (n=26).

Abbreviations: BAI, Beck Anxiety Inventory; BDI-II, Beck Depression Inventory-II; DPT, drug provocation test.

Figure 4 Comparison of the BAI and BDI-II scores before and after DPT according to the severity of drug hypersensitivity reaction. The BAI (A) and BDI-II (B) scores before and after DPT in the non- anaphylaxis group (black dots and lines) (n=22). The BAI (C) and BDI-II (D) scores before and after DPT in the anaphylaxis group (blank dots and lines) (n=24).

Abbreviations: BAI, Beck Anxiety Inventory; BDI-II, Beck Depression Inventory-II; DPT, drug provocation test.

Table 2 Predictive Factors for the Decrease in the BAI and BDI-II Scores After DPT in the Study Participants Using Univariate Logistic Regression

	BAI			BDI-II
	OR	CI	P	OR	CI	P
Female	2.167	0.674–6.962	0.194	1.500	0.472–4.771	0.492
Age	0.996	0.952–1.042	0.870	0.972	0.927–1.019	0.237
Bronchial asthma	0.955	0.123–7.408	0.965	0.792	0.102–6.151	0.823
Allergic rhinitis	1.482	0.394–5.579	0.560	3.176	0.734–13.749	0.122
Food allergy	0.950	0.207–4.350	0.947	0.773	0.168–3.546	0.740
Time interval between hypersensitivity reaction and DPT, months	0.995	0.982–1.009	0.478	1.013	0.992–1.035	0.220
Anaphylaxis	0.769	0.244–2.427	0.654	1.061	0.335–3.357	0.920
Antibiotics	1.587	0.490–5.138	0.441	0.833	0.258–2.688	0.760
NSAIDs	0.313	0.094–1.041	0.058	0.875	0.258–2.688	0.821
H2-blocker	0.290	0.028–3.013	0.300	0.792	0.102–6.151	0.823
Muscle-relaxant	0.955	0.123–7.408	0.965	2.609	0.251–27.113	0.422
Other drugs	0.375	0.095–1.482	0.162	1.179	0.313–4.442	0.808
Confirmation of drug hypersensitivity by DPT	1.750	0.537–5.701	0.353	1.286	0.395–4.188	0.677
BAI score before the DPT	1.107	1.010–1.213	0.030	1.017	0.991–1.157	0.083
BDI-II score before the DPT	1.128	1.029–1.238	0.010	1.113	1.017–1.218	0.020

Abbreviations: OR, odds ratio; CI, confidence interval; DPT, drug provocation test; NSAID, non-steroidal anti-inflammatory drug; BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory.