Perez-Sanchez, NataliaDoña, InmaculadaBogas, GadorSalas, MariaTestera, AlmudenaCornejo-Garcia, Jose A.Torres, Maria J.2022-04-012022-04-012020-04-21Pérez-Sánchez N, Doña I, Bogas G, Salas M, Testera A, Cornejo-García JA, et al. Evaluation of Subjects Experiencing Allergic Reactions to Non-Steroidal Anti-Inflammatory Drugs: Clinical Characteristics and Drugs Involved. Front Pharmacol. 2020 Apr 21;11:503http://hdl.handle.net/10668/3513Non-steroidal anti-inflammatory drugs (NSAIDs), the most commonly prescribed and consumed medicines worldwide, are the main triggers of drug hypersensitivity reactions (DHRs). The underlying mechanisms of NSAID-DHRs may be related to COX-1 inhibition (cross-hypersensitivity reactions, CRs) or to immunological recognition (selective reactions, SRs), being the latter remarkably less studied. SRs include those usually appearing within the first hour after drug intake (single-NSAID-induced urticaria/angioedema or anaphylaxis, SNIUAA), and those usually occurring more than 24 h after (single-NSAID-induced delayed reactions, SNIDR). We have evaluated the largest series of patients with SRs, analyzing the number of episodes and drugs involved, the latency for reaction onset, the clinical entities, among other variables, as well as the value of available diagnostic methods. Globally, pyrazolones and arylpropionics were the most frequent culprits (39.3% and 37.3%, respectively). Pyrazolones were the most frequent triggers in SNIUAA and arylpropionics in SNIDR. Urticaria was the most common clinical entity in SNIUAA (42.4%) followed by anaphylaxis (33.3%); whereas SNIDR induced mostly fixed drug eruption (41.1%) and maculopapular exanthema (32.6%). The percentage of patients diagnosed by clinical history was higher in SNIUAA compared with SNIDR (62.7% versus 35.3%, p = 0.00015), whereas the percentage of those diagnosed by skin tests was higher in SNIDR than in SNIUAA (47.1% versus 22.8%, p = 0.00015). Drug provocation test with the culprit was performed in 67 SNIUAA (14.5%) and in 9 SNIDR (17.6%) patients. Our results may be of interest not only for allergologists but also for other clinicians dealing with these drugs, and can be useful for the correct identification of subjects experiencing DHRs to NSAIDs, and for avoiding mislabeling. Moreover, as NSAIDs are highly consumed worldwide, our results may be of interest for evaluating other populations exposed to these drugs.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Drug allergyNon-steroidal anti-inflammatory drugsUrticarialAnaphylaxisClinical immunologyMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Inflammatory Agents::Anti-Inflammatory Agents, Non-SteroidalMedical Subject Headings::Diseases::Chemically-Induced Disorders::Drug-Related Side Effects and Adverse Reactions::Drug HypersensitivityMedical Subject Headings::Diseases::Immune System Diseases::Hypersensitivity::Hypersensitivity, Immediate::UrticariaMedical Subject Headings::Diseases::Immune System Diseases::HypersensitivityMedical Subject Headings::Diseases::Immune System Diseases::Hypersensitivity::Hypersensitivity, Immediate::AnaphylaxisMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Diseases::Immune System Diseases::Hypersensitivity::Hypersensitivity, Immediate::Urticaria::AngioedemaMedical Subject Headings::Diseases::Immune System Diseases::Hypersensitivity::Drug Hypersensitivity::Drug EruptionsMedical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Azoles::Pyrazoles::PyrazolonesMedical Subject Headings::Chemicals and Drugs::Pharmaceutical PreparationsMedical Subject Headings::Diseases::Skin and Connective Tissue Diseases::Skin Diseases::Exanthemaresearch article32425774open accessHipersensibilidad a las drogasAntiinflamatorios no esteroideosUrticariaAnafilaxia10.3389/fphar.2020.005031663-9812PMC7212440