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Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti‐inflammatory drugs
Author(s) -
Kowalski M. L.,
Asero R.,
Bavbek S.,
Blanca M.,
BlancaLopez N.,
Bochenek G.,
Brockow K.,
Campo P.,
Celik G.,
Cernadas J.,
Cortellini G.,
Gomes E.,
NiżankowskaMogilnicka E.,
Romano A.,
Szczeklik A.,
Testi S.,
Torres M. J.,
Wöhrl S.,
Makowska J.
Publication year - 2013
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12260
Subject(s) - medicine , nonsteroidal , aspirin , desensitization (medicine) , drug , drug reaction , drug allergy , intensive care medicine , anti inflammatory , adverse effect , pharmacology , receptor
Hypersensitivity reactions to aspirin (acetylsalicylic acid) and other nonsteroidal anti‐inflammatory drugs ( NSAID s) 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, NSAID s 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 E uropean A cademy of A llergy and C linical I mmunology T ask F orce on NSAID s H ypersensitivity, aims at reviewing the current knowledge in the field and proposes uniform definitions and clinically useful classification of hypersensitivity reactions to NSAID s. The document proposes also practical algorithms for the diagnosis of specific types of NSAID s 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.