D3.319 - Clinical Data of Drug Induced Anaphylaxis according to the standardized European Anaphylaxis Registry (NORA)

Anaphylaxis is a serious, life-threatening systemic hypersensitivity reaction that is often caused by drugs. The European Network for Online Registration of Anaphylaxis (NORA) is a standardized system for recording cases of anaphylaxis. The purpose of this study is to systematically record and evaluate drug-induced anaphylaxis (DIA) data using NORA.

Documented cases of DIA that were referred to the Allergy Unit, University General Hospital ‘Attikon’ from 2019 to 2023 were recorded using the NORA system, in an external archive. The World Allergy Organization (WAO) classification was used for grading the severity of the reactions.

A total of 66 patients were included, of whom 19 were men and 47 were women, with a median age of 53 (20-82) years. Drug induced Anaphylaxis (DIA) was more frequent in women (71.2%, p<0.01) and in middle-aged patients (35-65 years - 68.2%, p<0.01). The majority of the reactions were mild (53%), while the most frequent clinical manifestations were from the skin (84.8%, p<0.05). The most frequently implicated drugs were antibiotics (62.1%, p<0.01). It is noted that antibiotics more often caused mild reactions. Reactions occurred most frequently within the first 10 minutes of drug exposure (60.6%, p<0.01), while oral administration of the culprit was the most frequent (69.7%, p<0.01). Adrenaline was administered in only 36% of cases.

Drug-induced anaphylaxis mainly affects middle-aged and elderly patients with skin symptoms being the most prominent. Although adrenaline is the drug of choice for anaphylaxis regardless of etiology, its use is limited to nearly one third of the study population. The use of databases such as NORA contributes to the uniform recording of data and their comparative evaluation.