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Contents »

Delayed hypersensitivity to new oral anticoagulants. Demonstration of cross reactivity for the drug category and definition of non-irritant concentrations for patch tests


G. Cortellini1 gcortellini@libero.it, F. Rossi2, D. Lippolis1, F. Cortellini1, B. Gavioli3, G. Ballardini1

Show more: Authors information and Publication history

Doi
https://doi.org/10.23822/EurAnnACI.1764-1489.71

Summary
The current therapy with direct trombin inhibitors (DTI) is indicated for the prevention of stroke in non-valvular atrial fibrillation. Side effects are reported, particularly skin hypersensitivity, for this whole category of drugs as well as for other modern antiplatelet and anticoagulant drugs.
For their clinical features, these reactions appear as delayed T-cell mediated drug hypersensitivity, but at present there are no diagnostic methods of investigation. We reported a case of delayed skin reaction to edoxaban and we found the non-irritant concentration for patch test in the whole category of drugs.
The patch test resulted positive for edoxaban. A successive challenge with alternative DTIs and/or a switch to warfarin is proposed as alternative therapy.

Key words
direct trombin inhibitors; delayed hypersensitivity; edoxaban; atrial fibrillation; patch test