Journal ArticleDOI
Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs
Marek L. Kowalski,Riccardo Asero,Sevim Bavbek,Miguel Blanca,Natalia Blanca-López,Grazyna Bochenek,Knut Brockow,Paloma Campo,Gülfem Çelik,Josefina Cernadas,G Cortellini,Eva Rebelo Gomes,Ewa Nizankowska-Mogilnicka,Antonino Romano,Andrzej Szczeklik,S. Testi,María José Torres,Stefan Wöhrl,Joanna Makowska +18 more
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TLDR
This document, prepared by a panel of experts from the European Academy of Allergy and Clinical Immunology Task Force on NSAIDs Hypersensitivity, aims at reviewing the current knowledge in the field and proposes uniform definitions and clinically useful classification of hypersensitivity reactions to NSAIDs.Abstract:
Hypersensitivity reactions to aspirin (acetylsalicylic acid) and other nonsteroidal anti-inflammatory drugs (NSAIDs) constitute only a subset of all adverse reactions to these drugs, but due to their severity pose a significant burden to patients and are a challenge to the allergist. In susceptible individuals, NSAIDs induce a wide spectrum of hypersensitivity reactions with various timing, organ manifestations, and severity, involving either immunological (allergic) or nonimmunological mechanisms. Proper classification of reactions based on clinical manifestations and suspected mechanism is a prerequisite for the implementation of rational diagnostic procedures and adequate patient management. This document, prepared by a panel of experts from the European Academy of Allergy and Clinical Immunology Task Force on NSAIDs Hypersensitivity, aims at reviewing the current knowledge in the field and proposes uniform definitions and clinically useful classification of hypersensitivity reactions to NSAIDs. The document proposes also practical algorithms for the diagnosis of specific types of NSAIDs hypersensitivity (which include drug provocations, skin testing and in vitro testing) and provides, when data are available, evidence-based recommendations for the management of hypersensitive patients, including drug avoidance and drug desensitization.read more
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Journal ArticleDOI
Twenty Years' Experience with Anaphylaxis-Like Reactions to Local Anesthetics: Genuine Allergy is Rare.
TL;DR: Skin testing and provocative LA challenge are useful to exclude LA allergy, and this testing procedure seems to be appropriate to identify the extremely rare cases with IgE-mediated LA allergy.
Journal ArticleDOI
An Overview of Nonsteroidal Antiinflammatory Drug Reactions.
TL;DR: An in-depth review of NSAID classification, types ofNSAID reactions, diagnostic tactics, and management strategies are provided to provide the reader with a greater understanding of NSAIDs-induced reactions.
Journal ArticleDOI
Exercise-Induced Anaphylaxis: Literature Review and Recent Updates
TL;DR: Despite recent advances in the understanding of EIAn and FDEIAn, the pathophysiology of both conditions is not fully understood.
Journal ArticleDOI
H1-Antihistamine Premedication in NSAID-Associated Urticaria
TL;DR: In the majority of patients with NSAID-induced orNSAID-exacerbated urticaria concurrently suffering from intermittent pain, a premedication regimen with 5 mg desloratadine 30 minutes before intake of a strong COX-I inhibitor seems to be effective, safe, and practicable.
Journal ArticleDOI
SIAIP position paper: provocation challenge to antibiotics and non-steroidal anti-inflammatory drugs in children.
Carlo Caffarelli,Fabrizio Franceschini,Davide Caimmi,Francesca Mori,Lucia Diaferio,Dora Di Mauro,Carla Mastrorilli,Stefania Arasi,Simona Barni,Paolo Bottau,Silvia Caimmi,Fabio Cardinale,Pasquale Comberiati,Giuseppe Crisafulli,Lucia Liotti,Umberto Pelosi,Francesca Saretta,Gian Luigi Marseglia,Marzia Duse,Francesco Paravati +19 more
TL;DR: The Italian Pediatric Society for Allergy and Immunology provides a practical guide for provocation test to antibiotics and NSAIDs in children and adolescents.
References
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Journal ArticleDOI
Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients
Munir Pirmohamed,Sally James,Shaun Meakin,Chris D. Green,A Scott,Tom Walley,Keith Farrar,B. Kevin Park,Alasdair Breckenridge +8 more
TL;DR: The burden ofADRs on the NHS is high, accounting for considerable morbidity, mortality, and extra costs, and measures need to be put into place to reduce the burden of ADRs and thereby further improve the benefit:harm ratio of the drugs.
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A new system for grading recommendations in evidence based guidelines
Robin Harbour,Juliet Miller +1 more
TL;DR: A revised system of determining levels of evidence and grades for guideline recommendations is published, based on the work of the US Agency for Healthcare Research and Quality and its applicability to the target population of the guideline.
Journal ArticleDOI
Intolerance to Aspirin: Clinical Studies and Consideration of its Pathogenesis
Max Samter,Ray F. Beers +1 more
Journal ArticleDOI
Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations.
Werner Aberer,Andreas J. Bircher,Antonino Romano,Miguel Blanca,Paolo Campi,Javier Fernández,Knut Brockow,Werner J. Pichler,Pascal Demoly +8 more
TL;DR: A drug provocation test (DPT) is the controlled administration of a drug in order to diagnose drug hypersensitivity reactions under medical surveillance, whether this drug is an alternative compound, or structurally/pharmacologically related, or the suspected drug itself.
Journal ArticleDOI
Delayed Drug Hypersensitivity Reactions
TL;DR: This review presents newer concepts of the role of T cells in drug hypersensitivity, which evolved from the study of drug-specific T Cells in various drug-induced hypersensitivity diseases.
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