QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Verdel, B M. Articles by Leufkens, H. G. Search for Related Content PubMed PubMed Citation Articles by Verdel, B M. Articles by Leufkens, H. G.

ALLERGY

Difference in Risks of Allergic Reaction to Sulfonamide Drugs Based on Chemical Structure

Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, Netherlands

Patrick C Souverein, PhD

Epidemiologist, Division of Pharmacoepidemiology and Pharmacotherapy, UIPS

Antoine CG Egberts, PhD

Clinical Pharmacist, Hospital Pharmacy Midden-Brabant, TweeSteden Hospital and St. Elisabeth Hospital, Tilburg, Netherlands; Professor of Clinical Pharmacoepidemiology, Division of Pharmacoepidemiology and Pharmacotherapy, UIPS

Hubert GM Leufkens, PhD

Professor of Pharmacoepidemiology, Division of Pharmacoepidemiology and Pharmacotherapy, UIPS

Reprints: Dr. Verdel, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80082, 3508 TB Utrecht, Netherlands, fax 31 30 253 9166, b.m.verdel{at}pharm.uu.nl

BACKGROUND: The chemical structure of sulfonamide antibiotics and sulfonamide nonantibiotics can affect the potential for adverse reactions.

OBJECTIVE: To assess whether differences in chemical structure of the various sulfonamide drugs influence the risk of allergic events.

METHODS: A case-control study was conducted among patients with diabetes mellitus (DM) using data from the General Practice Research Database. Cases were defined as patients with a diagnosis of hypersensitivity or allergic reaction. The date of the last event was the index date. Controls were matched on practice, type of DM, and index date. Current use of sulfonamides was defined as use in a 14 day time window before the index date. Sulfonamides were classified according to the presence/absence of an N1 substituent (N1⁺/^-) and/or an arylamine (N4⁺/^-). Conditional logistic regression was used to estimate strength of association and expressed as odds ratios and 95% confidence intervals.

RESULTS: Overall, current use of N1⁺ N4⁺ sulfonamide drugs was associated with the outcome (adjusted OR 3.71; 95% CI 1.40 to 9.81). Current use of N1⁺ N4^- and N1^- N4^- sulfonamide drugs was also associated with the occurrence of allergic reactions, although not as strongly: adjusted OR 2.48 (95% CI 2.12 to 2.89) and 2.07 (95% CI 1.74 to 2.46), respectively. Sex and age seemed to be effect modifiers. There was no clear evidence for effect modification by immune disease state.

CONCLUSIONS: Although we did not identify major differences between the groups, we believe that this approach is an innovative manner to examine adverse drug reactions by using chemical structure instead of therapeutic drug classes to classify exposure.

Key Words: allergic reactions, chemical structure, diabetes mellitus, sulfonamide drugs

Published Online, May 30, 2006. www.theannals.com, DOI 10.1345/aph.1G642

This article has been cited by other articles:

				K. W Chamberlin and A. R Silverman Celecoxib-Associated Anaphylaxis Ann. Pharmacother., April 1, 2009; 43(4): 777 - 781. [Abstract] [Full Text] [PDF]

				E M W van de Garde, E Hak, P C Souverein, A W Hoes, J M M van den Bosch, and H G M Leufkens Statin treatment and reduced risk of pneumonia in patients with diabetes Thorax, November 1, 2006; 61(11): 957 - 961. [Abstract] [Full Text] [PDF]