Determinants of Placebo Reaction at Oral Provocation Test in Adults

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Rationale

Placebo-controlled oral provocation is an essential step in the management of drug allergy. To investigate reactions to placebo and features of placebo reaction was to aim of the study.

Methods

Data was collected from files of patients undergoing oral drug provocation (OPT) at tertiary level of outpatient adult allergy clinic. Placebo was used in the first day of OPT. On active drug day, either alternative drugs and/or suspected culprit drugs were used. All OPT was performed under strict control of both trained allergy nurse and allergy specialist. Demographic and clinical features of placebo reactors and non-reactors were compared.

Results

A total of 106 patients with 42.6±1.28 y mean age (F/M:68/38) were recruited consecutively. Among them, 23 (21.7%) reacted to placebo. Only 3 cases had visible urticarial plaques. Migratory itching with tingling sensation, tickling at throat, rhinorrhea, headache and dizziness was the other symptoms in the remaining placebo reactors. Higher education level (OR:3.15, 95%CI:1.19-8.27, p=0.03) and having comorbidities other than allergic disorders (OR:4.08, 95%CI: 1.46-11.42, p=0.009)was the only

Conclusions

Placebo reactions could have special clinical characteristics related with population and are not uncommon.

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