Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs in adults: Beyond current classification
Allergol. immunopatol
; 51(5)01 sept. 2023. tab
Article
in English
| IBECS
| ID: ibc-225051
Responsible library:
ES1.1
Localization: ES15.1 - BNCS
ABSTRACT
Background:
Hypersensitivity reactions (HSRs) to nonsteroidal anti-inflammatory drugs (NSAIDs) are a significant clinical issue. Several classifications have been proposed to categorize these reactions, including the current European Academy of Allergy and Clinical Immunology/European Network for Drug Allergy (EAACI/ENDA) classification. This study aimed to evaluate the applicability of this classification in a real-world clinical setting.Methods:
We conducted a national multicenter study involving patients from nine hospitals in four major urban centers in Turkey. All patients had a suggestive clinical history of hypersensitivity reactions to NSAIDs. Researchers collected data using a structured form and classified reactions based on the EAACI/ENDA classification. Oral provocation tests with several NSAIDs were performed using a single-blind challenge per EAACI/ENDA guidelines.Results:
Our retrospective study included 966 adult patients with a history of hypersensitivity to NSAIDs. The most common triggers were Acetylsalicylic Acid (ASA), paracetamol, and metamizole. The most prevalent acute NSAID hypersensitivity group was NSAID-induced urticaria/angioedema (NIUA) (34.3%). However, 17.3% of patients did not fit neatly into the current EAACI/ENDA classification. Notably, patients with underlying asthma or allergic rhinoconjunctivitis exhibited unusual reactions, such as urticaria and/or angioedema induced by multiple chemical groups of NSAIDs, blended mixed reactions, and isolated periorbital angioedema in response to multiple chemical groups of NSAIDs.Conclusions:
While the EAACI/ENDA classification system stratifies NSAID-induced hypersensitivity reactions into five distinct endotypes or phenotypes, it may not fully capture the diversity of these reactions. Our findings suggest a need for further research to refine this classification system and better accommodate patients with atypical presentations (AU)
Full text:
Available
Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Anti-Inflammatory Agents, Non-Steroidal
/
Drug Hypersensitivity
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Allergol. immunopatol
Year:
2023
Document type:
Article
Institution/Affiliation country:
Ankara University/Türkiye
/
Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital/Türkiye
/
Hacettepe University School of Medicine/Türkiye
/
Istanbul University/Türkiye
/
Maslak Hospital/Türkiye
/
Recep Tayyip Erdoğan University/Türkiye