Abstract：
BACKGROUND: Patch tests (PTs) are recommended to identify the culprit drug in non-immediate cutaneous adverse drug reactions (NICADRs). We recently reported that, in patients with NICADRs, a unique reading of PTs at day (D)2 compared with an additional second late reading at D4 missed almost half (45.3%) of the positive PTs.
OBJECTIVE: To assess the change in sensitivity of the PT reading on D4 compared with the reading on D3.
METHODS: We performed a retrospective (July 2020-June 2023) monocentric study of patients who had PTs with two readings for a NICADR. We compared reading on D3 and the second reading on D4 for the suspected drug (primary outcome) and for the related drugs tested simultaneously (secondary outcome).
RESULTS: During the study period, 249 patients underwent patch testing with D3 and D4 readings. Regarding the primary outcome, the first reading at D3 was positive for 13.7% of patients, and the reading at D4 for 24.9% of patients (p < 0.0001). Regarding the secondary outcome, only 9.6% of patients had all their positive PT at D3 compared with 24.9% of patients at D4 (p < 0.0001). Considering the evaluated drug classes, no statistical difference was observed. However, we highlight that D3 reading detected all positive carbamazepine PTs (n = 3) while positive clindamycin PTs (n = 4) were identified only with the help of the second reading on D4.
CONCLUSIONS: This study showed that, an additional D4 reading compared with a single D3 reading enhanced the sensitivity of PTs to identify culprit drugs and related. Further studies should replicate these findings and evaluate the medico-economic balance and safety of a single reading of PTs on D4.
OBJECTIVE: To assess the change in sensitivity of the PT reading on D4 compared with the reading on D3.
METHODS: We performed a retrospective (July 2020-June 2023) monocentric study of patients who had PTs with two readings for a NICADR. We compared reading on D3 and the second reading on D4 for the suspected drug (primary outcome) and for the related drugs tested simultaneously (secondary outcome).
RESULTS: During the study period, 249 patients underwent patch testing with D3 and D4 readings. Regarding the primary outcome, the first reading at D3 was positive for 13.7% of patients, and the reading at D4 for 24.9% of patients (p < 0.0001). Regarding the secondary outcome, only 9.6% of patients had all their positive PT at D3 compared with 24.9% of patients at D4 (p < 0.0001). Considering the evaluated drug classes, no statistical difference was observed. However, we highlight that D3 reading detected all positive carbamazepine PTs (n = 3) while positive clindamycin PTs (n = 4) were identified only with the help of the second reading on D4.
CONCLUSIONS: This study showed that, an additional D4 reading compared with a single D3 reading enhanced the sensitivity of PTs to identify culprit drugs and related. Further studies should replicate these findings and evaluate the medico-economic balance and safety of a single reading of PTs on D4.
摘要：
背景：建议使用斑贴试验（PT）来确定非即时皮肤药物不良反应（NICADR）的罪魁祸首。我们最近报道说,在NICADR患者中，第(D)2天的一次独特的PT读数与第D4天的第二次晚期读数相比,错过了几乎一半(45.3%)的阳性PT.
目的：评估D4上PT读数与D3上PT读数的敏感性变化。
方法：我们进行了一项回顾性（2020年7月至2023年6月）单中心研究，研究对象是患有PT的患者，其NICADR的读数为两个。我们比较了D3的读数和D4的第二次读数对可疑药物（主要结果）和同时测试的相关药物（次要结果）。
结果：在研究期间，249名患者接受了D3和D4读数的贴片测试。关于主要结果，13.7%的患者在D3时的第一次读数为阳性，和D4时的读数为24.9%的患者（p<0.0001）。关于次要结果，D3时仅9.6%的患者PT均为阳性,D4时则为24.9%(p<0.0001).考虑到评估的药物类别，没有观察到统计学差异。然而,我们强调，D3读数检测到所有卡马西平阳性PT（n=3），而克林霉素阳性PT（n=4）仅在D4的第二次读数的帮助下被鉴定。
结论：这项研究表明，与单一D3读数相比,额外的D4读数增强了PT识别罪魁祸首药物及相关药物的敏感性.进一步的研究应该复制这些发现，并评估D4上单次阅读PT的医学经济平衡和安全性。
目的：评估D4上PT读数与D3上PT读数的敏感性变化。
方法：我们进行了一项回顾性（2020年7月至2023年6月）单中心研究，研究对象是患有PT的患者，其NICADR的读数为两个。我们比较了D3的读数和D4的第二次读数对可疑药物（主要结果）和同时测试的相关药物（次要结果）。
结果：在研究期间，249名患者接受了D3和D4读数的贴片测试。关于主要结果，13.7%的患者在D3时的第一次读数为阳性，和D4时的读数为24.9%的患者（p<0.0001）。关于次要结果，D3时仅9.6%的患者PT均为阳性,D4时则为24.9%(p<0.0001).考虑到评估的药物类别，没有观察到统计学差异。然而,我们强调，D3读数检测到所有卡马西平阳性PT（n=3），而克林霉素阳性PT（n=4）仅在D4的第二次读数的帮助下被鉴定。
结论：这项研究表明，与单一D3读数相比,额外的D4读数增强了PT识别罪魁祸首药物及相关药物的敏感性.进一步的研究应该复制这些发现，并评估D4上单次阅读PT的医学经济平衡和安全性。
