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Immediate reactions to proton pump inhibitors: Clinical findings and testing outcomes

Akçam NY, Özden G, Çevirme L, Erkoç M

Allergologia et immunopathologia, 2025

47 participants

Abstract

Background: Proton pump inhibitors (PPIs) are identified to cause immediate hypersensitivity reactions and cross-reactivity among them. In this study, we aimed to describe the clinical features of immediate-type hypersensitivity reactions caused by PPIs, the results of drug tests performed with PPIs, and the cross-reactivity between PPIs. There are immediate hypersensitivity reactions with PPIs and there may be cross-reactivity between PPIs. In this study, we aimed to describe the clinical features of immediate-type hypersensitivity reactions caused by PPIs, the results of drug tests performed with PPIs and the cross-reactivity between PPIs.

Methods: Adult patients who described an immediate hypersensitivity reaction to PPIs between March 1, 2017 and March 1, 2023 were evaluated.

Results: Of the 47 patients included in the study, 89.4% were females, and the suspected PPI in 68% of the patients was lansoprazole. Anaphylaxis accounted for 72.3% of reactions, and the most common reaction was grade 2 (42.6%) according to Ring Messmer. Those who had two or more reactions to the same or different PPI were 51.1% of patients. A positivity rate of 43.8% was observed in the skin prick test with the suspected drug, 33.3% in the intradermal test, and 100% in the provocation test. There is varying potential for cross-reactivity among five different PPIs.

Conclusions: İmmediate hypersensitivity reactions are observed among PPIs, particularly to lansoprazole, with the majority of reactions…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 47 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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