{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:58:23Z","timestamp":1791284303866,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,12,12]],"date-time":"2016-12-12T00:00:00Z","timestamp":1481500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,12,12]],"date-time":"2016-12-12T00:00:00Z","timestamp":1481500800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2017,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n As a strong inducer of IgE antibodies to substituted ammonium ion epitopes (\n QAI<\/jats:styled-content>\n ), pholcodine (\n PHO<\/jats:styled-content>\n ) is a postulated cause of allergic anaphylaxis to neuromuscular blocking agents (\n NMBA<\/jats:styled-content>\n s). Three years after withdrawal of\n PHO<\/jats:styled-content>\n in Norway, a significant reduction in IgE sensitization and anaphylaxis reporting was seen.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n Six\u2010year follow\u2010up study on the effects of\n PHO<\/jats:styled-content>\n withdrawal on IgE sensitization and anaphylaxis reporting.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n From 650 acute consecutive reports (2005\u20132013) to the Norwegian Network for Anaphylaxis under Anaesthesia (\n NARA<\/jats:styled-content>\n ), total number of reports on suspected anaphylactic reactions, number of reactions where\n NMBA<\/jats:styled-content>\n s were administered, number of reactions where serum IgE antibodies (\u22650.35\n \n kU\n A<\/jats:sub>\n <\/jats:styled-content>\n \/l) to suxamethonium (\n SUX<\/jats:styled-content>\n ) and\n PHO<\/jats:styled-content>\n were present at time of reaction and anaphylaxis severity grades were retrieved. In addition,\n NMBA<\/jats:styled-content>\n sales and prevalence of IgE sensitization to\n PHO<\/jats:styled-content>\n and\n SUX<\/jats:styled-content>\n among \u2018allergics\u2019 were monitored.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n From baseline period P0 (\n PHO<\/jats:styled-content>\n on the market) through the first (P1) and second (P2), three\u2010year periods after withdrawal, significant falls in total reports (\n P<\/jats:italic>\n < 0.001) and reports with IgE antibodies to\n PHO<\/jats:styled-content>\n (\n P<\/jats:italic>\n = 0.008) and\n SUX<\/jats:styled-content>\n (\n P<\/jats:italic>\n = 0.001) at time of reaction were found. Total\n NMBA<\/jats:styled-content>\n sales in P2 were 83% of P0, and\n SUX<\/jats:styled-content>\n and rocuronium (\n ROC<\/jats:styled-content>\n ) together made up 86% of sales throughout the study. Five\n NMBA<\/jats:styled-content>\n \u2010related anaphylactic deaths occurred during P0 and P1 and, however, none during P2. Prevalence of IgE sensitization to\n SUX<\/jats:styled-content>\n in \u2018allergics\u2019 fell to 0% at 4 and 5 years after withdrawal.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Six years after\n PHO<\/jats:styled-content>\n withdrawal, the Norwegian population has become significantly less IgE\u2010sensitized and clinically more tolerant to\n NMBA<\/jats:styled-content>\n s.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/all.13081","type":"journal-article","created":{"date-parts":[[2016,11,9]],"date-time":"2016-11-09T20:20:12Z","timestamp":1478722812000},"page":"813-819","source":"Crossref","is-referenced-by-count":50,"title":["Six years without pholcodine; Norwegians are significantly less IgE\u2010sensitized and clinically more tolerant to neuromuscular blocking agents"],"prefix":"10.1111","volume":"72","author":[{"given":"G. H.","family":"de Pater","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Florvaag","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Biochemistry Haukeland University Hospital Bergen Norway"},{"name":"Department of Occupational Medicine Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Science University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. G. O.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Medicine Clinical Immunology and Allergy Unit Karolinska Institute Stockholm Sweden"},{"name":"Department of Clinical Immunology and Transfusion Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5.","family":"Irgens","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. N. H.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. B.","family":"Guttormsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Medicine Section of Anaesthesiology and Intensive Care University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161208786369704"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2007.01313.x"},{"key":"e_1_2_8_4_1","first-page":"285","article-title":"Allergy and anaphylaxis in anaesthesia","volume":"70","author":"Mertes PM","year":"2004","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05733.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200505000-00006"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12426"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh203"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200014020-00003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02598.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/306262a0"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2004.00591.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2009.04.002"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00933.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01554.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.01983.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.02193.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.5415\/apallergy.2014.4.2.86"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12189"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2010.02518.x"},{"key":"e_1_2_8_21_1","first-page":"127","article-title":"Allergic reactions during anesthesia \u2013 a national network for registration, diagnosis and follow\u2010up","volume":"120","author":"Guttormsen AB","year":"2000","journal-title":"Tidsskr Nor Laegeforen"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)91953-5"},{"key":"e_1_2_8_23_1","volume-title":"IBM SPSS Statistics for Windows, Version 22.0","author":"IBM Corp","year":"2013"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2001.451005.x"},{"key":"e_1_2_8_25_1","unstructured":"EMA\/890819.Questions and answers on the review of the marketing authorisations for medicines containing pholcodine.www.ema.europa.eu 2011."},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/WOX.0b013e318261eccc"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00785.x"},{"key":"e_1_2_8_28_1","first-page":"868","article-title":"Hypersensitivity reactions during anesthesia. 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