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Metamizole-associated neutropenia: Comparison of patients with neutropenia and metamizole-tolerant patients

Rudin, Deborah and Spoendlin, Julia and Cismaru, Anca L. and Liakoni, Evangelia and Bonadies, Nicolas and Amstutz, Ursula and Meier, Christoph R. and Krähenbühl, Stephan and Haschke, Manuel. (2019) Metamizole-associated neutropenia: Comparison of patients with neutropenia and metamizole-tolerant patients. European journal of internal medicine, 68. pp. 36-43.

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Official URL: https://edoc.unibas.ch/74304/

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Abstract

Reports of metamizole-induced neutropenia have increased in Switzerland and Germany over the last decades, most likely reflecting increased use of metamizole. To date, there are no effective strategies to identify patients at increased risk of metamizole-induced neutropenia. In this observational, multi-center comparative study, characteristics of patients with metamizole-associated neutropenia were compared with patients treated with metamizole without developing adverse hematological reactions. Patients with metamizole-induced neutropenia treated at the University Hospitals Basel and Bern between 2005 and 2017 were included. Tolerant comparison patients with continuous metamizole treatment (≥500 mg/day for at least 28 days) were recruited from GP offices and community pharmacies. Forty-eight patients with metamizole-induced neutropenia, consisting of 23 and 25 cases with inpatient-acquired and outpatient-acquired neutropenia, respectively, were compared to 39 metamizole tolerant comparison patients. Median latency until first diagnosis of neutropenia was 6 days (1-61 days) in inpatient cases and 19 days (2-204 days) in outpatient cases. There was no association between non-myelotoxic and non-immunosuppressive co-medication (p = .6627), history of drug allergy (p = .1304), and preexisting auto-immune diseases (p = .2313) and the development of metamizole-induced neutropenia. Our results suggest that autoimmune diseases, history of drug allergy, and concomitant treatment with non-myelotoxic and non-immunosuppressive drugs are likely not individual risk factors for metamizole-associated neutropenia.
Faculties and Departments:05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Klinische Pharmazie/Spitalpharmazie (Meier)
UniBasel Contributors:Meier, Christoph R.
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1879-0828
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:27 May 2020 10:24
Deposited On:27 May 2020 10:24

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