Epidemiology of drug hypersensitivity reactions using 6-year national health insurance claim data from Korea
Abstract
Background Drug hypersensitivity reactions (DHRs) constitute a large portion of adverse drug reactions (ADRs), but studies for DHR incidence based on national data are scarce. Objective This study aimed to estimate the incidence and patterns of DHRs in a Korean population and the associated utilization of medical resources using the national claims data. Setting The retrospective cohort study performed using the national insurance claim database of the Health Insurance Review and Assessment (HIRA) in Korea. Methods The International Classification of Disease 10th revision code was used to identify DHRs with 20 drug induced DHR codes. The claim data with a diagnosis of DHR in the 2009-2014 periods were analyzed. Main outcome and measure The annual incidence and the 6-year incidence rates were calculated. Incidence rate coefficients were analyzed by sex, age, and year. DHRs following with visits of emergency department (ED) or intensive care unit (ICU) were assessed for utilization of medical resources and risk of ER or ICU visits by sex and age Results A total of 535,049 patients with 1,083,507 claims were assessed in the HIRA database for 6 years. DHR incidence was high in the elderly. The risk of ED and ICU visit with DHR was also higher in the elderly than in the young [highest relative risk, RR of ED 2.59 (1.65–4.07), ICU 5.04 (2.50–10.18)]. DHRs related to blood were high in the young age. Conclusion Incidence of DHRs in the real-world clinical practice was higher in the elderly and female. Clinical consequence was more severe in the elderly.
Keywords
Adverse drug reactions (ADRs) Drug hypersensitivity Health insurance database Incidence KoreaNotes
Funding
This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Ministry of Science, ICT & Future Planning, Republic of Korea (No. 2013M3A9B5075838).
Conflicts of interest
The authors have no conflicts of interest that are directly relevant to the content of this study.
Supplementary material
References
- 1.Thong BY, Tan T. Epidemiology and risk factors for drug allergy. Br J Clin Pharmacol. 2011;71:684–700.CrossRefPubMedPubMedCentralGoogle Scholar
- 2.Kongkaew C, Noyce PR, Ashcroft DM. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Ann Pharmacother. 2008;42:1017–25.CrossRefPubMedGoogle Scholar
- 3.Demoly P, Hillaire-Buys D. Classification and epidemiology of hypersensitivity drug reactions. Immunol Allergy Clin North Am. 2004;24:345–56.CrossRefPubMedGoogle Scholar
- 4.Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356:1255–9.CrossRefPubMedGoogle Scholar
- 5.Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International consensus on drug allergy. Allergy. 2014;69:420–37.CrossRefPubMedGoogle Scholar
- 6.Doña I, Barrionuevo E, Blanca-Lopez N, Torres M, Fernandez T, Mayorga C, et al. Trends in hypersensitivity drug reactions: more drugs, more response patterns, more heterogeneity. J Investig Allergol Clin Immunol. 2014;24:143–53.PubMedGoogle Scholar
- 7.Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol. 2005;5:309–16.CrossRefPubMedGoogle Scholar
- 8.Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296:1858–66.CrossRefPubMedGoogle Scholar
- 9.Turner PJ, Gowland MH, Sharma V, Ierodiakonou D, Harper N, Garcez T, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992–2012. J Allergy Clin Immunol. 2015;135(956–63):e1.Google Scholar
- 10.Heinzerling L, Tomsitz D, Anliker M. Is drug allergy less prevalent than previously assumed? A 5-year analysis. Br J Dermatol. 2012;166:107–14.CrossRefPubMedGoogle Scholar
- 11.Kim B, Kim J, Kang M, Yang M, Park H, Min K, et al. Allergies are still on the rise? A 6-year nationwide population-based study in Korea. Allergol Int. 2016;65:186–91.CrossRefPubMedGoogle Scholar
- 12.Lee CH, Kim J, Jang EJ, Kim YJ, Choi S, Lee JH, et al. Healthcare utilisation by pregnant patients with asthma in South Korea: a cohort study using nationwide claims data. BMJ Open. 2015;5:e008416.CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Kim JY, Lee J, Ko Y, Shin J, Jung S, Choi N, et al. Multi-indication carbamazepine and the risk of severe cutaneous adverse drug reactions in Korean elderly patients: a Korean health insurance data-based study. PLoS ONE. 2013;8:e83849.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Stausberg J, Hasford J. Drug-related admissions and hospital-acquired adverse drug events in Germany: a longitudinal analysis from 2003 to 2007 of ICD-10-coded routine data. BMC Health Serv Res. 2011;11:134.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Stausberg J, Hasford J. Identification of adverse drug events. Dtsch Arztebl Int. 2010;107:23–9.PubMedPubMedCentralGoogle Scholar
- 16.Benkhaial A, Kaltschmidt J, Weisshaar E, Diepgen TL, Haefeli WE. Prescribing errors in patients with documented drug allergies: comparison of ICD-10 coding and written patient notes. Pharm World Sci. 2009;31:464–72.CrossRefPubMedGoogle Scholar
- 17.Vandenbroucke JP, Pearce N. Incidence rates in dynamic populations. Int J Epidemiol. 2012;41:1472–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Roujeau J, Haddad C, Paulmann M, Mockenhaupt M. Management of nonimmediate hypersensitivity reactions to drugs. Immunol Allergy Clin North Am. 2014;34:473–87.CrossRefPubMedGoogle Scholar
- 19.Çelik G, Karakaya G, Öztürk A, Gelincik A, Abadoğlu Ö, Sin A, et al. Drug allergy in tertiary care in Turkey: results of a national survey. The ADAPT study: adult drug allergy perception in Turkey. Allergol Immunopathol. 2014;42:573–9.CrossRefGoogle Scholar
- 20.Dodiuk-Gad RP, Laws PM, Shear NH. Epidemiology of severe drug hypersensitivity. Semin Cutan Med Surg. 2014;33:2–9.CrossRefPubMedGoogle Scholar
- 21.Chung WH, Wang CW, Dao RL. Severe cutaneous adverse drug reactions. J Dermatol. 2016;43:758–66. https://doi.org/10.1111/1346-8138.13430.CrossRefPubMedGoogle Scholar
- 22.Kano Y, Tohyama M, Aihara M, Matsukura S, Watanabe H, Sueki H, et al. Sequelae in 145 patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms: Survey conducted by the Asian Research Committee on Severe Cutaneous Adverse Reactions (ASCAR). J Dermatol. 2015;42:276–82.CrossRefPubMedGoogle Scholar
- 23.Yang MS, Kang MG, Jung JW, Song WJ, Kang HR, Cho SH, et al. Clinical features and prognostic factors in severe cutaneous drug reactions. Int Arch Allergy Immunol. 2013;162:346–54.CrossRefPubMedGoogle Scholar
- 24.Victor FC, Cohen DE, Soter NA. A 20-year analysis of previous and emerging allergens that elicit photoallergic contact dermatitis. J Am Acad Dermatol. 2010;62:605–10.CrossRefPubMedGoogle Scholar
- 25.Gomes ER, Kuyucu S. Epidemiology and risk factors in drug hypersensitivity reactions. Curr Treat Options Allergy. 2017;4:239–57.CrossRefGoogle Scholar
- 26.Hierro Santurino B, Mateos Conde J, Cabero Moran MT, Miron Canelo JA, Armentia Medina A. A predictive model for the diagnosis of allergic drug reactions according to the medical history. J Allergy Clin Immunol Pract. 2016;4(292–300):e3.Google Scholar
- 27.Rubio M, Bousquet P, Gomes E, Romano A, Demoly P. Results of drug hypersensitivity evaluations in a large group of children and adults. Clin Exp Allergy. 2012;42:123–30.CrossRefPubMedGoogle Scholar
- 28.Batzing-Feigenbaum J, Schulz M, Schulz M, Hering R, Kern WV. Outpatient antibiotic prescription. Dtsch Arztebl Int. 2016;113:454–9.PubMedPubMedCentralGoogle Scholar
- 29.Yoon YK, Park GC, An H, Chun BC, Sohn JW, Kim MJ. Trends of antibiotic consumption in Korea according to national reimbursement data (2008–2012): a population-based epidemiologic study. Medicine (Baltimore). 2015;94:e2100.CrossRefGoogle Scholar
- 30.Schmidt M, Hallas J, Friis S. Potential of prescription registries to capture individual-level use of aspirin and other nonsteroidal anti-inflammatory drugs in Denmark: trends in utilization 1999–2012. Clin Epidemiol. 2014;6:155–68.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Garratty G. Immune hemolytic anemia associated with drug therapy. Blood Rev. 2010;24:143–50.CrossRefPubMedGoogle Scholar
- 32.Sokol RJ, Hewitt S, Stamps BK, Hitchen PA. Autoimmune haemolysis in childhood and adolescence. Acta Haematol. 1984;72:245–57.CrossRefPubMedGoogle Scholar
- 33.Black C, Tagiyeva-Milne N, Helms P, Moir D. Pharmacovigilance in children: detecting adverse drug reactions in routine electronic healthcare records. A systematic review. Br J Clin Pharmacol. 2015;80:844–54.CrossRefPubMedPubMedCentralGoogle Scholar
- 34.Sullivan JE, Farrar HC. Section on clinical pharmacology and therapeutics, committee on drugs. Fever and antipyretic use in children. Pediatrics. 2011;127:580–7.CrossRefPubMedGoogle Scholar
- 35.Stockwell MS, Broder K, LaRussa P, Lewis P, Fernandez N, Sharma D, et al. Risk of fever after pediatric trivalent inactivated influenza vaccine and 13-valent pneumococcal conjugate vaccine. JAMA Pediatr. 2014;168:211–9.CrossRefPubMedGoogle Scholar
- 36.Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch–Schonlein): current state of knowledge. Curr Opin Rheumatol. 2013;25:171–8.CrossRefPubMedGoogle Scholar
- 37.Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ, et al. Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. Arthritis Care Res. 2015;67:817–28.CrossRefGoogle Scholar
- 38.Mitsuhata H, Matsumoto S, Hasegawa J. The epidemiology and clinical features of anaphylactic and anaphylactoid reactions in the perioperative period in Japan. Masui. 1992;41:1664–9.PubMedGoogle Scholar
- 39.Gibbs N, Sadleir P, Clarke R, Platt P. Survival from perioperative anaphylaxis in Western Australia 2000–2009. Br J Anaesth. 2013;111:589–93.CrossRefPubMedGoogle Scholar
- 40.Light KP, Lovell AT, Butt H, Fauvel NJ, Holdcroft A. Adverse effects of neuromuscular blocking agents based on yellow card reporting in the U.K.: are there differences between males and females? Pharmacoepidemiol Drug Saf. 2006;15:151–60.CrossRefPubMedGoogle Scholar
- 41.Hepner DL, Castells MC. Anaphylaxis during the perioperative period. Anesth Analg. 2003;97:1381–95.CrossRefPubMedGoogle Scholar
- 42.Volcheck GW, Mertes PM. Local and general anesthetics immediate hypersensitivity reactions. Immunol Allergy Clin North Am. 2014;34:525–46.CrossRefPubMedGoogle Scholar
- 43.Yu S-J, Gang I-S. A comparative study on the process of hospital visits according to the characteristics of the elderly visiting to emergency medical centers. Korean J Health Serv Manag. 2014;8:27–39.CrossRefGoogle Scholar
- 44.Nates JL, Nunnally M, Kleinpell R, Blosser S, Goldner J, Birriel B, et al. ICU admission, discharge, and triage guidelines: 000 framework to enhance clinical operations, development of institutional policies, and further research. Crit Care Med. 2016;44:1553–602.CrossRefPubMedGoogle Scholar
- 45.Sekula P, Dunant A, Mockenhaupt M, Naldi L, Bavinck JNB, Halevy S, et al. Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. J Investig Dermatol. 2013;133:1197–204.CrossRefPubMedGoogle Scholar
- 46.Chen YC, Huang HH, Fan JS, Chen MH, Hsu TF, Yen DH, et al. Comparing characteristics of adverse drug events between older and younger adults presenting to a Taiwan emergency department. Medicine (Baltimore). 2015;94:e547.CrossRefGoogle Scholar
- 47.Tanno LK, Calderon MA, Goldberg BJ, Akdis CA, Papadopoulos NG, Demoly P. Categorization of allergic disorders in the new World Health Organization International Classification of Diseases. Clin Transl Allergy. 2014;4:42.CrossRefPubMedPubMedCentralGoogle Scholar
- 48.Tanno LK, Calderon MA, Goldberg BJ, Gayraud J, Bircher AJ, Casale T, et al. Constructing a classification of hypersensitivity/allergic diseases for ICD-11 by crowdsourcing the allergist community. Allergy. 2015;70:609–15.CrossRefPubMedGoogle Scholar
- 49.Tanno LK, Calderon M, Papadopoulos NG, Demoly P, EAACI/WAO Task force of a Global Classification of Hypersensitivity/Allergic diseases. Mapping hypersensitivity/allergic diseases in the International Classification of Diseases (ICD)-11: cross-linking terms and unmet needs. Clin Transl Allergy. 2015;5:20.CrossRefPubMedPubMedCentralGoogle Scholar
- 50.Tanno LK, Calderon MA, Demoly P. Joint Allergy Academies. New allergic and hypersensitivity conditions section in the International Classification of Diseases-11. Allergy Asthma. Immunol Res. 2016;8:383–8.Google Scholar