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

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

  • Rudin D Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Schanzenstrasse 55, 4031 Basel, Switzerland; Department of Biomedicine, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland. Electronic address: deborah.rudin@unibas.ch.
  • Spoendlin J Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, University of Basel, St. Johanns-Vorstadt 27, 4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031 Basel, Switzerland. Electronic address: julia.spoendlin@usb.ch.
  • Cismaru AL Division of Clinical Chemistry, Inselspital Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: anca.cismaru@extern.insel.ch.
  • Liakoni E Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Institute of Pharmacology, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: evangelia.liakoni@insel.ch.
  • Bonadies N Department of Hematology and Central Hematology Laboratory, Inselspital Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: nicolas.bonadies@insel.ch.
  • Amstutz U Division of Clinical Chemistry, Inselspital Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: ursula.amstutz@insel.ch.
  • Meier CR Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, University of Basel, St. Johanns-Vorstadt 27, 4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031 Basel, Switzerland. Electronic address: christoph.meier@usb.ch.
  • Krähenbühl S Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Schanzenstrasse 55, 4031 Basel, Switzerland; Department of Biomedicine, University of Basel, Hebelstrasse 20, 4031 Basel, Switzerland. Electronic address: stephan.kraehenbuehl@usb.ch.
  • Haschke M Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Institute of Pharmacology, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: manuel.haschke@insel.ch.
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  • 2019-08-07
Published in:
  • European journal of internal medicine. - 2019
Adverse drug reaction
Agranulocytosis
Metamizole
Neutropenia
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal
Autoimmune Diseases
Case-Control Studies
Dipyrone
Drug Hypersensitivity
Drug Interactions
Female
Humans
Male
Middle Aged
Neutropenia
Risk Factors
Young Adult
English 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/228009
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