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Nsaids crossed hypersensitivity

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: Subjects who develop drug hypersensitivity reactions (DHRs) to chemically unrelated non-steroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this category is that they present a reaction after ASA intake or challenge. Whether patients react to two or more NSAIDs with tolerance to ASA remains to be studied (selective reactions, SRs). OBJECTIVE: To identify patients with SRs to two or more NSAIDs including strong COX-1 inhibitors...
May 18, 2016: Journal of Investigational Allergology & Clinical Immunology
J A Cornejo-García, R Jurado-Escobar, I Doña, J R Perkins, J A Agúndez, E García-Martín, E Viguera, N Blanca-López, G Canto, M Blanca
DHRs are induced by various mechanisms and encompass a heterogeneous set of potentially life-threatening clinical entities. In addition to environmental effects, individual factors play a key role in this intricate puzzle. However, despite commendable efforts in recent years to identify individual predisposing factors, our knowledge of the genetic basis of these reactions remains incomplete. In this manuscript, we summarize current research on the genetics of DHRs, focusing on specific immune-mediated reactions (immediate and nonimmediate) and on pharmacologically mediated reactions (cross-intolerance to nonsteroidal anti-inflammatory drugs)...
2016: Journal of Investigational Allergology & Clinical Immunology
Blanca Noguerado-Mellado, Abdonias Rodriguez Gamboa, Patricia Rojas Perez-Ezquerra, Cristina Morales Cabeza, Roberto Pelta Fernandez, Manuel De Barrio Fernandez
BACKGROUND: Naproxen is a non-steroidal anti-inflammatory drug (NSAID), belonging to propionic acid group, and its chemical structure is a 6-metoxi-metil-2-naftalenoacetic acid. Fixed drug eruptions (FDE) have been rarely reported. OBJECTIVE: A 38-year-old woman referred that after 2 hours of taking 2 tablets of naproxen for a headache, she developed several edematous and dusky-red macules, one on right forearm and the other two in both thighs and she was diagnosed with FDE probably due to naproxen...
April 4, 2016: Recent Patents on Inflammation & Allergy Drug Discovery
Duy Le Pham, Ji-Hye Kim, Tu Hoang Kim Trinh, Hae-Sim Park
Nonsteroidal anti-inf lammatory drugs (NSAIDs) are widely prescribed for the treatment of inflammatory diseases, but their use is frequently related to hypersensitivity reactions. This review outlines our current knowledge of NSAID hypersensitivity (NHS) with regard to its pathogenic, molecular, and genetic mechanisms, as well as diagnosis and treatment. The presentation of NHS varies from a local (skin and/or airways) reaction to systemic reactions, including anaphylaxis. At the molecular level, NHS reactions can be classified as cross-reactive (mediated by cyclooxygenase inhibition) or selective (specific activation of immunoglobulin E antibodies or T cells)...
May 2016: Korean Journal of Internal Medicine
María Del Carmen Plaza-Serón, Pedro Ayuso, Natalia Pérez-Sánchez, Inmaculada Doña, Natalia Blanca-Lopez, Carlos Flores, Luisa Galindo, Ana Molina, James R Perkins, Jose A Cornejo-García, Jose A Agúndez, Elena García-Martín, Paloma Campo, Gabriela Canto, Miguel Blanca
OBJECTIVE: Cross-intolerance to NSAIDs is a class of drug hypersensitivity reaction, of which NSAIDs-induced urticaria and/or angioedema (NIUA) are the most frequent clinical entities. They are considered to involve dysregulation of the arachidonic acid pathway; however, this mechanism has not been confirmed for NIUA. In this work, we assessed copy number variations (CNVs) in eight of the main genes involved in the arachidonic acid pathway and their possible genetic association with NIUA...
June 2016: Pharmacogenetics and Genomics
N Blanca-López, D Pérez-Alzate, I Andreu, I Doña, J A Agúndez, E García-Martín, M Salas, M Á Miranda, M J Torres, J A Cornejo-García, M Blanca, G Canto
BACKGROUND: Although ibuprofen and other arylpropionic acid derivatives (APs) are the most common medicines involved in hypersensitivity drug reactions (HDRs) to NSAIDs, no patient series studies have been performed regarding immediate selective reactions (SRs) to these drugs. OBJECTIVE: To characterize patients with immediate selective HDRs to ibuprofen and other APs through clinical history and challenge. METHODS: Subjects who developed an HDR to APs less than 1 h after drug intake were included...
July 2016: Allergy
N Blanca-López, J A Cornejo-García, D Pérez-Alzate, N Pérez-Sánchez, M C Plaza-Serón, I Doña, M J Torres, G Canto, M Kidon, J R Perkins, M Blanca
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used throughout the world to treat pain and inflammation; however, they can trigger several types of drug hypersensitivity reactions (DHRs) in all age groups. Although most such reactions occur through activation of the leukotriene pathway without specific immunological recognition (cross-intolerance), a significant number of DHRs to NSAIDs are due to immunological mechanisms (selective reactions [SRs]). SRs are thought to be induced by specific IgE antibodies or by T cells...
2015: Journal of Investigational Allergology & Clinical Immunology
Ozlem Cavkaytar, Ebru Arik Yilmaz, Betul Karaatmaca, Betul Buyuktiryaki, Cansın Sackesen, Bulent E Sekerel, Ozge Soyer
BACKGROUND: Although non-steroidal anti-inflammatory drug hypersensitivity (NSAID-H) has been widely studied in adults, there is still a lack of data regarding the features and phenotypes of NSAID-H in children. Our aim was to define risk factors and different phenotypes according to clinical patterns. METHODS: Patients with a history of reaction to any NSAIDs referred between January 2012 and October 2014 were included. After completing a European Network for Drug Allergy (ENDA) questionnaire, initial skin and/or oral provocation tests (OPTs) were performed for the offending drug...
2015: International Archives of Allergy and Immunology
Hakan Guvenir, Emine Dibek Misirlioglu, Emine Vezir, Muge Toyran, Tayfur Ginis, Ersoy Civelek, Can N Kocabas
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAID) are the second-most frequent drugs that cause hypersensitivity reactions among children. Studies related to NSAIDs hypersensitivity in children are limited. In this study, we aimed to evaluate children admitted with suspicion of NSAIDs reaction. METHOD: Between January 1, 2011, and November 30, 2014, we included patients with suspicion of NSAIDs hypersensitivity in our clinic. For evaluation, skin tests and oral provocation tests with the drug (suspected or alternative) were proposed...
September 2015: Allergy and Asthma Proceedings:
C Rondón, I Dávila, A M Navarro Pulido, M C Sánchez, J Montoro, V Matheu, M Lluch-Bernal, B Fernández-Parra, M D Ibáñez, M T Dordal, C Colás, E Antón, A Valero
BACKGROUND: Nasal polyposis (NP) is a chronic inflammatory disease that constitutes a major health problem with significant comorbidities and a considerable associated socioeconomic burden. OBJECTIVE: To describe the clinical features and management of patients with NP attending Spanish allergy centers, the use of health care resources, and the degree of compliance with the diagnostic and therapeutic recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS)...
2015: Journal of Investigational Allergology & Clinical Immunology
N Blanca-López, J A Cornejo-García, M C Plaza-Serón, I Doña, M J Torres-Jaén, G Canto, L Padilla-España, M Kidon, J R Perkins, M Blanca
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used worldwide and are responsible for several types of drug hypersensitivity reactions (DHRs) in all age groups. The 2 major groups of DHRs to NSAIDs are those induced by immunological mechanisms (selective reactions) and those where inflammatory mediators are released through activation of the prostaglandin-leukotriene pathway without specific immunological recognition (cross-intolerance). In the present review, we focus on cross-intolerance reactions, which are the most frequent DHRs and are becoming a topic of major interest in children and adolescents...
2015: Journal of Investigational Allergology & Clinical Immunology
Marek L Kowalski, Katharine Woessner, Marek Sanak
Nonsteroidal anti-inflammatory drug (NSAID)-induced urticarial and angioedema reactions are among the most commonly encountered drug hypersensitivity reactions in clinical practice. Three major clinical phenotypes of NSAID-induced acute skin reactions manifesting with angioedema, urticaria, or both have been distinguished: NSAID-exacerbated cutaneous disease, nonsteroidal anti-inflammatory drug-induced urticaria/angioedema (NIUA), and single NSAID-induced urticaria and angioedema. In some patients clinical history alone might be sufficient to establish the diagnosis of a specific type of NSAID hypersensitivity, whereas in other cases oral provocation challenges are necessary to confirm the diagnosis...
August 2015: Journal of Allergy and Clinical Immunology
S Demir, M Olgac, D Unal, A Gelincik, B Colakoglu, S Buyukozturk
BACKGROUND/AIM: The consensus document for hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) proposed by the European Network for Drug Allergy (ENDA) interest group (2011) was revised in 2013. We aimed to evaluate the usability of the latest NSAID hypersensitivity classification of ENDA. METHOD: A total of 370 patients with a history of hypersensitivity reactions to NSAIDs among the 1250 outpatients referred for suspected drug allergy between July 2013 and June 2014 were evaluated, and 308 patients who were confirmed as having NSAID hypersensitivity were included in this study...
November 2015: Allergy
Elena García-Martín, Gara Esguevillas, Natalia Blanca-López, Jesús García-Menaya, Miguel Blanca, Gemma Amo, Gabriela Canto, Carmen Martínez, Concepción Cordobés, José A G Agúndez
Metamizole is a NSAID that has been banned in several countries because of its toxicity. It is often involved in selective hypersensitivity reactions and most hypersensitivity patients develop anaphylaxis. Metamizole is rapidly metabolized, and metabolic profiles are related to genetic factors. We analyzed whether genetic determinants of metamizole metabolism influence the risk of developing hypersensitivity in 265 patients diagnosed with hypersensitivity to metamizole and 362 healthy individuals who tolerated metamizole...
September 2015: Pharmacogenetics and Genomics
Christoffer V Nissen, Carsten Bindslev-Jensen, Charlotte G Mortz
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are reported to be the second most common cause of drug hypersensitivity. In 2011, experts from the EAACI/ENDA group and GA(2)LEN proposed a new classification system for NSAID hypersensitivity. The aim of this study was to classify a patient cohort with a history of NSAID hypersensitivity according to this system. METHODS: Patients with a clinical history of NSAID hypersensitivity referred to the Allergy Centre, Odense University Hospital between 2002 and 2011 and evaluated with oral provocation tests (OPTs) were included in the study...
2015: Clinical and Translational Allergy
Francisco Soares Nascimento-Sampaio, Mylene dos Santos Leite, Donald Arthur Leopold, Suzam Guedes Oliva da Silva, Paulo Adriano Schwingel, Carlos Maurício Cardeal Mendes, Adelmir Souza-Machado, Régis de Albuquerque Campos
BACKGROUND: A better understanding of severe uncontrolled asthma (UA) in the upper airways is needed. The aims of this study were to assess the prevalence of upper airway abnormalities and their associations with UA. METHODS: An observational study enrolled individuals with severe asthma. Sociodemographic and clinical questionnaires regarding asthma, rhinosinusitis, and laryngopharyngeal reflux (LPR) were administered. Skin-prick tests and fiber optic nasolaryngoscopies were also performed...
May 2015: International Forum of Allergy & Rhinology
Wenyin Loh, Hwee Hoon Lim, Rajeshwar Rao, Anne Goh, Lin Xin Ong, Wen Chin Chiang
BACKGROUND: Cyclooxygenase-2 (COX-2) inhibitors have been found to be safe alternatives in adults with cross-intolerant hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). However they are usually not prescribed in children and there is little information about their tolerance in the pediatric age group. OBJECTIVE: This study aims to evaluate the tolerance to etoricoxib in children with hypersensitivity to multiple antipyretics. METHODS: A retrospective case series of children diagnosed with hypersensitivity reactions to NSAIDs and/or paracetamol who underwent a drug provocation test (DPT) with etoricoxib...
January 2015: Asia Pacific Allergy
Yuval Tal, Alon Hersheko, Arnon Broides, Iran Asher, Tali Staubers, Ronit Confino-Cohen, Nancy Agmon-Levin
Drug hypersensitivity is an adverse reaction that was brought-about by a specific immunologic response. Some of these reactions are Linked with significant morbidity and mortality. Nowadays, hypersensitivity reactions to most drugs can be well defined and the risk of re-exposure to the culprit drug and/or related drugs can be properly assessed. Medical history, skin, blood and challenge tests, conducted in an allergy clinic, enable the prediction and prevention of repeated events as well as unnecessary avoidance of needed compounds...
October 2014: Harefuah
Ahmad A Mourad, Sami L Bahna
NSAIDs are the most commonly used medications worldwide and are responsible for almost 25% of adverse drug reactions. Such reactions can have different manifestations and can be immunologic or non-immunologic. The diagnosis is primarily based on the medical history, which can be difficult in patients receiving multiple medications. Because skin testing and blood tests are not valid for NSAIDs reactions, confirmation requires an appropriately-designed challenge. The latter could be avoided when the history is obvious and the reaction is life-threatening...
September 2014: Expert Review of Clinical Immunology
Jennifer Poh, Sandra Knowles
BACKGROUND: One of the cornerstones of the management of inflammatory bowel disease is the use of 5-aminosalicylic acid (5-ASA) compounds for treatment of flares and as maintenance therapy during remission. There are concerns about using 5-ASA in patients with a history of hypersensitivity to acetylsalicylic acid (ASA). OBJECTIVE: To assess the literature with respect to the safety of 5-ASA compounds in patients with documented sensitivity to ASA or nonsteroidal anti-inflammatory drugs (NSAIDs)...
January 2014: Canadian Journal of Hospital Pharmacy
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