Allergic Reactions to Clopidogrel and Cross-Reactivity to Other Agents.
Summary of "Allergic Reactions to Clopidogrel and Cross-Reactivity to Other Agents."
Clopidogrel is a widely used antiplatelet agent, particularly after coronary stent implantation. About 1% of patients have allergic or hematologic adverse reactions to clopidogrel. This has important therapeutic implications, as premature discontinuation of clopidogrel is the strongest risk factor for stent thrombosis. Clopidogrel allergy most commonly manifests as a rash. It is important to distinguish this from other causes of rash occurring in patients who have had a recent coronary stent. Although antihistamines and short-term oral corticosteroids are effective in treating most clopidogrel hypersensitivity reactions, some persistent reactions may require discontinuation of clopidogrel. When discontinuation of clopidogrel is required, substitution with an alternative thienopyridine such as ticlopidine traditionally has been performed. However, a recent study suggests that there may be as high as a 27% risk of recurrence of non-life-threatening allergic reactions in such patients, which are usually similar to the allergic reactions that occurred with clopidogrel. No data are available regarding the frequency of cross-reactivity to prasugrel and ticagrelor; these may be potential therapeutic options in some patients.
Affiliation
First Coast Cardiovascular Institute, P.A., 3900 University Boulevard South, Jacksonville, FL, 32216, USA, drjuzar@gmail.com.
Journal Details
This article was published in the following journal.
Name: Current allergy and asthma reports
ISSN: 1534-6315
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20941557
- DOI: http://dx.doi.org/10.1007/s11882-010-0152-9
Medical and Biotech [MESH] Definitions
Anti-allergic Agents
Agents that are used to treat allergic reactions. Most of these drugs act by preventing the release of inflammatory mediators or inhibiting the actions of released mediators on their target cells. (From AMA Drug Evaluations Annual, 1994, p475)
Immunologic Techniques
Techniques involving the demonstration or measurement of an immune response, including antibody production or assay, ANTIGEN-ANTIBODY REACTIONS, serologic cross-reactivity, DELAYED HYPERSENSITIVITY reactions, IMMUNIZATION, or heterogenetic responses.
Dermatitis, Contact
A type of acute or chronic skin reaction in which sensitivity is manifested by reactivity to materials or substances coming in contact with the skin. It may involve allergic or non-allergic mechanisms.
Aspergillosis, Allergic Bronchopulmonary
Hypersensitivity reaction (ALLERGIC REACTION) to fungus ASPERGILLUS in an individual with long-standing BRONCHIAL ASTHMA. It is characterized by pulmonary infiltrates, EOSINOPHILIA, elevated serum IMMUNOGLOBULIN E, and skin reactivity to Aspergillus antigen.
Photosensitivity Disorders
Abnormal responses to sunlight or artificial light due to extreme reactivity of light-absorbing molecules in tissues. It refers almost exclusively to skin photosensitivity, including sunburn, reactions due to repeated prolonged exposure in the absence of photosensitizing factors, and reactions requiring photosensitizing factors such as photosensitizing agents and certain diseases. With restricted reference to skin tissue, it does not include photosensitivity of the eye to light, as in photophobia or photosensitive epilepsy.
PubMed Articles
OBJECTIVES: The purpose of this study was to characterize clopidogrel hypersensitivity and describe its successful management with oral steroids without clopidogrel discontinuation. BACKGROUND: Hypers...
Pistachio Allergy-Prevalence and In vitro Cross-Reactivity with Other Nuts.
Background: Tree nut allergy is characterized by a high frequency of life-threatening reactions and is typically lifelong persistent. Some people with a pistachio nut allergy, which is common in the p...
Anaphylaxis to Buckwheat in an Atopic Child: A Risk Factor for Severe Allergy to Nuts and Seeds?
Common buckwheat (Fagopyrum esculentum) is known to cause severe anaphylactic reactions in adult individuals. However, type I allergy to buckwheat is rarely seen in children. We report on a 7-year-old...
This study sought to investigate the efficacy, safety, and antiplatelet effect of prasugrel as compared with clopidogrel in patients with high on-treatment platelet reactivity (HTPR) after elective pe...
BACKGROUND: The platelet inhibitor clopidogrel is administered to patients treated with therapeutic hypothermia following cardiac arrest due to acute coronary syndromes. Interactions with proton pump...
Clinical Trials
The purpose of the study is to determine whether administration of 150 mg clopidogrel is effective in reducing the one-year incidence of thromboischemic events in patients with high on-clo...
Analysis of Immunological Reactions to Foods in Birch Pollen-Allergic Patients
A high number of birch pollen-allergic individuals develop hypersensitivity reactions to certain foods, e.g. apples. This food allergy is due to immunological cross-reactivity. Birch polle...
Single center randomized parallel group study to determine if: 1. there is a temporary increase in platelet reactivity after abrupt discontinuation of clopidogrel due to a potentia...
Resistance to Antithrombotic Therapy
Clopidogrel plays a pivotal role in the antithrombotic regimen after percutaneous intervention with stent implantation. However, response to clopidogrel shows a wide interindividual variab...
Plavix, Prasugrel and Drug Eluting Stents Pilot Trial
- The purpose of this study is to determine the level of inhibition of platelet activation of an approved thienopyridine(clopidogrel or prasugrel) and aspirin regimen in the...
