Date Published: April 3, 2013
Publisher: BioMed Central
Author(s): Anca Mirela Chiriac, Pascal Demoly.
Drug provocation tests (DPTs) are often needed when evaluating patients with suspected drug hypersensitivity reactions. General considerations on DPTs, with regard to indications, contraindications, methods, limitations and interpretations have been thoroughly addressed and various protocols are published. However, the field of drug allergy is changing and DPTs make no exception. Novel (or sometimes, simply renewed) approaches arise, awaiting to be either validated or refuted in larger studies in the future. Instead of covering the whole topic of DPTs, this paper will address these recent and challenging aspects.
Drug provocation test (DPT) comes at the end of a step-wise approach in the drug allergy work-up. While there is general agreement that it is the procedure that holds the finest sensitivity amongst all the other available diagnostic tools, and that it may considerably improve patient management, its use as “gold standard” to establish (rather than just to exclude) the diagnosis of drug hypersensitivity reaction (DHR), is not unanimously accepted, due to the reactions it may trigger, depending on the severity of the index reaction.
Whether the point of interest of the different groups working in the drug allergy field moves from the medical (indications/contraindications, results) to the technical (methodology) aspects of DPTs, or even addresses the patients perspective (PROs, satisfaction, NPV), the disclosure of such challenging and various results can only improve patient management. It remains to be seen which of these novel approaches will stand the test of time, and receive validation by larger studies.
The authors declare that they have no competing interests.
Both authors read and approved the final manuscript.