Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement
Emilio Álvarez-Cuesta, Ricardo Madrigal‐Burgaleta, Ana Dioun Broyles, Javier Cuesta‐Herranz, María Antonieta Guzman-Melendez, Michelle C. Maciag, Elizabeth J. Phillips, Jason A. Trubiano, Johnson T. Wong, Ignacio J. Ansotegui, Faisal Ali, Denisse Ángel Pereira, Aleena Banerji, María Pilar Berges‐Gimeno, Lorena Bernal-Rubio, Knut Brockow, Ricardo Cardona Villa, Mariana Castells, Jean‐Christoph Caubet, Yoon‐Seok Chang, Luís Felipe Ensina, Manana Chikhladze, Anca Mirela Chiriac, Weng-Hung Chung, Motohiro Ebisawa, Bryan Fernandes, Lene H. Garvey, Maximiliano Gómez, Javier Goméz Vera, Sandra Nora González Díaz, David I. Hong, Juan Carlos Ivancevich, Hye‐Ryun Kang, David A. Khan, Merin Kuruvilla, José Ignacio Larco Sousa, Patricia Latour-Staffeld, Anne Y. Liu, Eric Macy, Hans Jørgen Malling, Jorge Máspero, Sara May, Cristobalina Mayorga, Miguel A. Park, Jonny Peter, Matthieu Picard, Tito Rodriguez-Bouza, Antonino Romano, Mario Sánchez‐Borges, Luciana Kase Tanno, Marı́a José Torres, Alicia Ureña-Tavera, Rocco Luigi Valluzzi, Gerald W. Volcheck, Masao Yamaguchi
Abstract
testing, drug provocation testing) to ensure safety, an accurate diagnosis, and personalized management. Unfortunately, there are significant inequalities within and among countries in access to allergy departments with the necessary expertise and resources to offer these techniques and tackle these DHRs optimally. The main objective of this consensus document is to create a great benefit for patients worldwide by aiding allergists to expand the scope of their practice and support them with evidence, data, and experience from leading groups from around the globe. This statement of the Drug Hypersensitivity Committee of the World Allergy Organization (WAO) aims to be a comprehensive practical guide on the technical aspects of implementing acute-onset intravenous hypersensitivity delabeling and RDD for a wide range of drugs. Thus, the manuscript does not only focus on clinical pathways. Instead, it also provides guidance on topics usually left unaddressed, namely, internal validation, continuous quality improvement, creating a healthy multidisciplinary environment, and redesigning care (including a specific supplemental section on a real-life example of how to design a dedicated space that can combine basic and complex diagnostic and therapeutic techniques in allergy).