Data‐driven step doses for drug provocation tests to nonsteroidal anti‐inflammatory drugs

Allergy ◽  
2020 ◽  
Vol 75 (6) ◽  
pp. 1423-1434 ◽  
Author(s):  
Dunya Nohra ◽  
Nicolas Molinari ◽  
Pascal Demoly ◽  
Anca‐Mirela Chiriac
Keyword(s):  
Data Driven ◽  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests

Ipersensibilità ai FANS: intolleranza o allergia?

2021 ◽  
Vol 40 (1) ◽  
pp. 37-43
Author(s):  
Laura Levantino ◽  
Cristiana Corrado ◽  
Laura Badina ◽  
Sara Lega ◽  
Egidio Barbi
Keyword(s):  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Immunological Mechanisms ◽  
Drug Hypersensitivity Reactions ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests ◽  
Cox 1

Non-steroidal anti-inflammatory drugs (NSAIDs) are the main triggers of drug hypersensitivity reactions in children. According to the EAACI latest classification NSAIDs hypersensitivity reactions are differentiated into cross-reactive reactions, with non-immunological mechanisms (based on COX-1 inhibition), and selective reactions, with immunological mechanisms. Paediatric clinical manifestations of NSAID hypersensitivity are typically cutaneous, but sometimes, similarly to anaphylaxis, can involve other systems, especially the respiratory one. Differentiating between NSAID intolerance and NSAID allergy through drug provocation tests is crucial for the patient because the two clinical entities require different management.

Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children

2013 ◽  
Vol 24 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Maria A. Zambonino ◽  
Maria J. Torres ◽  
Candelaria Muñoz ◽  
Gloria Requena ◽  
Cristobalina Mayorga ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Drug Provocation Tests

scholarly journals Drug-induced anaphylaxis—elicitors, mechanisms and diagnosis

2019 ◽  
Vol 28 (8) ◽  
pp. 327-329
Author(s):  
Margitta Worm ◽  
Theresa Hanschmann-Mohn ◽  
Kathrin Scherer Hofmeier ◽  
Victòria Cardona ◽  
Paul Turner ◽  
...  
Keyword(s):  
Drug Induced ◽  
International Guidelines ◽  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Drugs are one of the major causes of anaphylaxis. For example 2346 cases of drug-induced anaphylaxis were reported to the anaphylaxis register as of March 2019. The most common triggers of drug-induced anaphylaxis were nonsteroidal anti-inflammatory drugs (NSAIDs; n = 902) and antibiotics (n = 721). Drug-induced anaphylaxis can be caused by IgE-dependent (e.g., penicillins) and IgE-independent mechanisms. Recently MRG-PX2 has been identified as a receptor for non-IgE-dependent mechanisms. Drug-induced anaphylaxis results more frequently in lethal reactions and is more commonly associated with cardiovascular symptoms. Also therapy refractory anaphylaxis is more frequently triggered by drugs. For the diagnosis of drug-induced anaphylaxis current national and international guidelines should be followed including provocation tests to avoid future reactions.

Provocation tests with the offending nonsteroidal anti-inflammatory drugs in patients with urticaria/angioedema reactions

2012 ◽  
Vol 33 (5) ◽  
pp. 421-426 ◽  
Author(s):  
Giuliana Zisa ◽  
Francesca Riccobono ◽  
Luisa Bommarito ◽  
Cristian D'Antonio ◽  
Ambra Marianna Calamari ◽  
...  
Keyword(s):  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Negative predictive value of provocation tests for nonsteroidal anti-inflammatory drugs in children

2020 ◽  
Vol 41 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Ozge Yilmaz Topal ◽  
Kulhas C. Ilknur ◽  
Yagmur T. Irem ◽  
Toyran Muge ◽  
Civelek Ersoy ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Provocation Test ◽  
Allergy Clinic ◽  
Predictive Values ◽  
Pediatric Allergy ◽  
Provocation Tests ◽  
Drug Classes ◽  
Drug Provocation Test ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: After antibiotics, nonsteroidal anti-inflammatory drugs (NSAID) are one of the leading drug classes responsible for hypersensitivity reactions in children. The drug provocation test (DPT) is the criterion standard for diagnosis. Objective: The aim of the present study was to determine the negative predictive values (NPV) of DPTs with NSAIDs in pediatric patients and to evaluate their attitudes toward NSAID use after a negative DPT result. Methods: The study included all patients who had undergone DPTs between January 1, 2014, and December 31, 2018, in our pediatric allergy clinic for suspected NSAID hypersensitivity reaction and who had a negative result for the suspected agent. Those patients who could be contacted were asked whether the patient had used the same drug again since the DPT and, if so, whether he or she had a reaction. Patients who were reported to have had a reaction were invited to the clinic for reevaluation. Based on the findings from this retesting, the NPVs of the DPTs with NSAIDs were calculated. Results: During the 5-year study period, DPT results were negative for 230 suspected agents in 215 patients. Of these, 143 patients (66.5%) were able to be contacted. A total of 108 patients (75.5%) had used the tested NSAIDs at least once after the provocation test, and five patients (4.6%) reported a reaction on reexposure. Four of these patients declined reevaluation, one patient exhibited no reaction in a second DPT. Therefore, the NPV was calculated as 96.3% (94.3% for ibuprofen, and 100% for paracetamol). Conclusion: The NPVs of DPTs with NSAIDs, especially of paracetamol DPT, is high in children. This finding should reassure the parents of patients who may require NSAID therapy again.

Safety and Outcomes of 2-step Non-steroidal Anti-inflammatory Drug Provocation Tests in the Outpatient Setting

2021 ◽  
Vol 147 (2) ◽  
pp. AB147
Author(s):  
Lily Li ◽  
Kathleen Buchheit ◽  
Jillian Bensko ◽  
Rebecca Saff ◽  
Tanya Laidlaw
Keyword(s):  
Outpatient Setting ◽  
Inflammatory Drug ◽  
Provocation Tests ◽  
Anti Inflammatory ◽  
Drug Provocation Tests

Avoidance of nonsteroidal anti-inflammatory drugs after negative provocation tests in urticaria/angioedema reactions: Real-world experience

2014 ◽  
Vol 35 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Luisa Bommarito ◽  
Giuliana Zisa ◽  
Francesca Riccobono ◽  
Elisa Villa ◽  
Cristian D'Antonio ◽  
...  
Keyword(s):  
Real World ◽  
Provocation Tests ◽  
Inflammatory Drugs ◽  
Anti Inflammatory
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