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Nsaid hypersensitivity

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https://www.readbyqxmd.com/read/28211343/immediate-reactions-to-more-than-1-nsaid-must-not-be-considered-cross-hypersensitivity-unless-tolerance-to-asa-is-verified
#1
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND AND OBJECTIVES: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28110055/adverse-and-hypersensitivity-reactions-to-prescription-nonsteroidal-anti-inflammatory-agents-in-a-large-health-care-system
#2
Kimberly G Blumenthal, Kenneth H Lai, Mingshu Huang, Zachary S Wallace, Paige G Wickner, Li Zhou
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in the United States. NSAID use can be limited by adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs). OBJECTIVE: We aimed to use electronic health record data to determine the incidence and predictors of HSRs to prescription NSAIDs. METHODS: We performed a retrospective cohort study of all adult outpatients in a large health care system prescribed diclofenac, indomethacin, nabumetone, or piroxicam between January 1, 2004, and September 30, 2012...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28102057/periostin-in-exhaled-breath-condensate-and-in-serum-of-asthmatic-patients-relationship-to-upper-and-lower-airway-disease
#3
Aleksandra Wardzyńska, Joanna S Makowska, Małgorzata Pawełczyk, Aleksandra Piechota-Polańczyk, Marcin Kurowski, Marek L Kowalski
PURPOSE: Periostin is considered a biomarker for eosinophilic airway inflammation and have been associated with NSAID-Exacerbated Respiratory Disease (NERD) and chronic rhinosinusitis (CRS). In this study, we aimed to evaluate periostin in exhaled breath condensate (EBC) and in serum of patients with various asthma phenotypes. METHODS: The study included 40 asthmatic patients (22 with NERD) and 17 healthy controls. All the procedures (questionnaire, spirometry, FeNO, nasal swabs, EBC collecting, and blood sampling) were performed on the same day...
March 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28049210/hypersensitivity-reactions-to-nonsteroidal-anti-inflammatory-drugs-among-adults-clinical-features-and-risk-factors-for-diagnosis-confirmation
#4
Eva Rebelo Gomes, Luísa Geraldes, Ângela Gaspar, Daniela Malheiro, Susana Cadinha, Carmo Abreu, Marta Chambel, Eugénia Almeida, Emília Faria
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Laboratory investigations are mostly used for research purposes. Different phenotypes have been described. OBJECTIVE AND METHODS: Our aim was to describe the most common clinical manifestations of NSAID HS in a large population of adult patients, the drugs involved, the association with previously described risk factors, and the outcome of diagnostic procedures...
2016: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/27865769/discrepancies-in-the-diagnosis-and-classification-of-nonsteroidal-anti-inflammatory-drug-hypersensitivity-reactions-in-children
#5
Tuğba Arikoglu, Gulen Aslan, Didem Derici Yildirim, Sehra Birgul Batmaz, Semanur Kuyucu
BACKGROUND: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently encountered in daily clinical practice. The aim of this study was to determine the confirmation rates, risk factors of NSAID hypersensitivity in children and to try to classify them with a standardized diagnostic protocol. METHODS: All patients with a suspicion of NSAID-induced hypersensitivity were evaluated with European Network for drug Allergy (ENDA) recommendations...
November 16, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/27865540/cofactors-and-comorbidities-in-patients-with-aspirin-nsaid-hypersensitivity
#6
REVIEW
M Sánchez-Borges, F Caballero-Fonseca, A Capriles-Hulett
Hypersensitivity reactions to aspirin and other NSAIDs occur in individuals genetically predisposed and exhibit different clinical manifestations, especially respiratory, cutaneous, and generalised. Five different phenotypes define distinct clinical pictures: aspirin-exacerbated respiratory disease, aspirin/NSAID cutaneous disease, NSAID-induced urticaria, angio-oedema and anaphylaxis, single NSAID reactions, and delayed reactions. They are observed more frequently in middle-aged women, and in atopic individuals...
November 16, 2016: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/27779086/genetic-predictors-of-drug-hypersensitivity
#7
José A Cornejo-García, Abderrahim Oussalah, Miguel Blanca, Rosa-María Guéant-Rodríguez, Cristobalina Mayorga, Julie Waton, Annick Barbaud, Francesco Gaeta, Antonino Romano, Jean-Louis Guéant
Our knowledge of genetic predisposing factors of drug hypersensitivity reactions (DHRs) is still scarce. The analysis of the genetic basis of these reactions may contribute to dissect the underlying mechanisms. We will outline current knowledge of the genetic predictors of most common DHRs, including reactions to betalactam antibiotics (BLs), nonsteroidal anti-inflammatory drugs (NSAIDs) and biological agents. The predictors of DHRs to BLs are mostly linked to IgE-class switching, IgE pathway and atopy (IL4R, NOD2, LGALS3) in replicated candidate gene studies, and to antigen presentation (HLA-DRA) in the single replicated GWAS performed so far...
September 27, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27779082/hypersensitivity-reactions-to-non-steroidal-anti-inflammatory-drugs
#8
Inmaculada Doña, María Salas, James R Perkins, Esther Barrionuevo, Francesco Gaeta, Jose A Cornejo-García, Paloma Campo, Maria José Torres
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs, and they are classified in two groups: those induced by non-specific immunological mechanisms (non-allergic or cross-intolerance (CI) reactions), or by specific immunological mechanisms (allergic or selective reactions (SR)). The pathogenesis of CI is associated with their pharmacological activity (COX-1 inhibition), with symptoms due to an imbalance in the arachidonic acid pathway, independently of their chemical structure...
September 28, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27746735/fceri-and-histamine-metabolism-gene-variability-in-selective-responders-to-nsaids
#9
Gemma Amo, José A Cornejo-García, Jesus M García-Menaya, Concepcion Cordobes, M J Torres, Gara Esguevillas, Cristobalina Mayorga, Carmen Martinez, Natalia Blanca-Lopez, Gabriela Canto, Alfonso Ramos, Miguel Blanca, José A G Agúndez, Elena García-Martín
The high-affinity IgE receptor (Fcε RI) is a heterotetramer of three subunits: Fcε RIα, Fcε RIβ, and Fcε RIγ (αβγ2) encoded by three genes designated as FCER1A, FCER1B (MS4A2), and FCER1G, respectively. Recent evidence points to FCERI gene variability as a relevant factor in the risk of developing allergic diseases. Because Fcε RI plays a key role in the events downstream of the triggering factors in immunological response, we hypothesized that FCERI gene variants might be related with the risk of, or with the clinical response to, selective (IgE mediated) non-steroidal anti-inflammatory (NSAID) hypersensitivity...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27732743/clinical-approach-on-challenge-and-desensitization-procedures-with-aspirin-in-patients-with-ischemic-heart-disease-and-nonsteroidal-anti-inflammatory-drug-hypersensitivity
#10
G Cortellini, A Romano, A Santucci, A Barbaud, S Bavbek, D Bignardi, M Blanca, P Bonadonna, M T Costantino, J J Laguna, C Lombardo, L M Losappio, J Makowska, A Nakonechna, O Quercia, E A Pastorello, V Patella, I Terreehorst, S Testi, J R Cernadas, J Dionicio Elera, D Lippolis, S Voltolini, D Grosseto
BACKGROUND: Hypersensitivity to acetylsalicylic acid (ASA) constitutes a serious problem for subjects with coronary artery disease. In such subjects, physicians have to choose the more appropriate procedure between challenge and desensitization. As the literature on this issue is sparse, this study aimed to establish in these subjects clinical criteria for eligibility for an ASA challenge and/or desensitization. METHODS: Collection and analysis of data on ASA challenges and desensitizations from 10 allergy centers, as well as consensus among the related physicians and an expert panel...
October 12, 2016: Allergy
https://www.readbyqxmd.com/read/27712761/diagnostic-evaluation-in-aspirin-exacerbated-respiratory-disease
#11
Adam N Williams
Aspirin-exacerbated respiratory disease (AERD) is a distinct clinical condition characterized by chronic sinusitis with nasal polyps, asthma, and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Distinguishing AERD from other forms of chronic sinusitis, asthma, and NSAID reactivity has important clinical implications for management. The clinical history is helpful, but not adequate for confirming the diagnosis of AERD, in most cases. Diagnostic provocation challenge remains the only way to confirm or exclude the diagnosis of AERD...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712759/an-overview-of-nonsteroidal-antiinflammatory-drug-reactions
#12
REVIEW
Kristen M Walters, Katharine M Woessner
Nonsteroidal antiinflammatory drugs (NSAIDs), including aspirin, are among the most commonly used drugs worldwide. They account for a large number of adverse drug reactions (ADRs). The prevalence of NSAID-induced reactions is increasing. Distinguishing between a predicted side effect of a drug and a potentially life-threatening hypersensitivity reaction is essential to manage the affected patient. However, most clinicians find it difficult to diagnose these types of reactions despite published classification schemes...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27673644/testing-for-hypersensitivity-to-nonsteroidal-anti-inflammatory-drugs-nsaids-at-the-university-hospital-zagreb
#13
I Kraljickovic, V Erdeljic Turk, I Cegec, D Juricic Nahal, M Radacic Aumiler, K Makar Ausperger, R Likic, I Simic
No abstract text is available yet for this article.
October 6, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27669963/specific-aspects-of-drug-hypersensitivity-in-children
#14
M Marcel Bergmann, Jean Christoph Caubet
Suspicion for drug hypersensitivity (DH) is a common reason for children's referral to an allergy department, with β-lactam antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) as the most frequently involved drugs. The prevalence of DH in children remains not well defined as epidemiologic studies in children are lacking, and the most of those take into account adverse drug reactions without a systematic allergy work-up to confirm or exclude hypersensitivity. The clinical history is mandatory in order to classify the reaction as being immediate or non-immediate and then to subsequently adapt the allergy work-up...
September 26, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27582398/eicosanoid-mediators-in-the-airway-inflammation-of-asthmatic-patients-what-is-new
#15
REVIEW
Marek Sanak
Lipid mediators contribute to inflammation providing both pro-inflammatory signals and terminating the inflammatory process by activation of macrophages. Among the most significant biologically lipid mediators, these are produced by free-radical or enzymatic oxygenation of arachidonic acid named "eicosanoids". There were some novel eicosanoids identified within the last decade, and many of them are measurable in clinical samples by affordable chromatography-mass spectrometry equipment or sensitive immunoassays...
November 2016: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27578463/nonsteroidal-anti-inflammatory-drug-nsaid-exacerbated-respiratory-disease-phenotype-topical-nsaid-and-asthma-control-a-possible-oversight-link
#16
Jessica Han Ying Tan, Anne Ann Ling Hsu
BACKGROUND: Patients with aspirin-exacerbated respiratory disease (AERD) also recently known as nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (NERD) must avoid aspirin and all other oral NSAIDs. The effect of topical NSAID (tNSAID), especially salicylates which are commonly present in topical medicated preparations, on asthma control of this phenotype is studied. METHODS: The study inclusion criteria were adults with: 1) NSAID hypersensitivity; 2) nasal polyposis/chronic rhinosinusitis; 3) not well-/poorly controlled asthma and 4) exposure to tNSAID...
September 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27576781/mucosal-exfoliation-as-a-selective-reaction-to-etoricoxib
#17
M Patanè, S Isola, S Gangemi, P L Minciullo
WHAT IS KNOWN AND OBJECTIVE: Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) that inhibits the inducible cyclooxygenase (COX-2) with a good safety profile. We describe the first case of two mucosal adverse events to etoricoxib in the same patient. CASE DESCRIPTION: Our patient developed stomatitis with mucosal exfoliation after etoricoxib assumption. Some months later, after a new etoricoxib intake, she presented with vaginal burning, tongue angioedema and erosions, oral exfoliation and wheals on the hands...
December 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27489545/asthma-and-rhinitis-induced-by-selective-immediate-reactions-to-paracetamol-and-non-steroidal-anti-inflammatory-drugs-in-aspirin-tolerant-subjects
#18
Diana Pérez-Alzate, Natalia Blanca-López, Inmaculada Doña, José A Agúndez, Elena García-Martín, José A Cornejo-García, James R Perkins, Miguel Blanca, Gabriela Canto
In subjects with non-steroidal anti-inflammatory drugs (NSAIDs)- exacerbated respiratory disease (NERD) symptoms are triggered by acetyl salicylic acid (ASA) and other strong COX-1 inhibitors, and in some cases by weak COX-1 or by selective COX-2 inhibitors. The mechanism involved is related to prostaglandin pathway inhibition and leukotriene release. Subjects who react to a single NSAID and tolerate others are considered selective responders, and often present urticaria and/or angioedema and anaphylaxis (SNIUAA)...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27475775/non-steroidal-anti-inflammatory-drug-hypersensitivity-in-children
#19
C Alves, A M Romeira, C Abreu, P Carreiro-Martins, E Gomes, P Leiria-Pinto
INTRODUCTION: There are rather few publications about hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAID) in the paediatric age. In this study, we aimed to assess the frequency of confirmed NSAID hypersensitivity in children with a previous reported reaction to NSAID in order to investigate the role of the drug provocation test (DPT) in the diagnostic workup and to explore the factors associated with confirmed NSAID hypersensitivity. METHODS: We conducted a retrospective analysis of the clinical files from every patient under 18 years old who attended two Portuguese paediatric allergy outpatient clinics, from January 2009 to August 2014, due to a suspected NSAID hypersensitivity...
January 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/27466843/aspirin-exacerbated-respiratory-disease
#20
REVIEW
Kai Fruth, Jan Gosepath
Aspirin exacerbated respiratory disease (AERD) has been defined as a non-steroidal anti-inflammatory drug (NSAID)-triggered hypersensitivity, non-allergic bronchial asthma and chronic rhinosinusitis (CRS) with nasal polyps. The underlying pathophysiology of AERD is not completely understood so far. An altered arachidonic acid metabolism and dysregulated enzyme activity are regarded to be causal. AERD is characterized by recalcitrant CRS with recurrent nasal polyps after sinus surgery, accompanied by difficult to treat bronchial asthma and adverse reaction after NSAID ingestion such as nasal blockage, itching, laryngospasm and severe asthma attacks...
2016: Advances in Oto-rhino-laryngology
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