A new classification option for NSAID hypersensitivity

Abstract

Background: The European Network for Drug Allergy (ENDA) proposed a consensus document for hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in 2011. A subgroup of patients with NSAIDs-exacerbated respiratory disease (NERD) develop urticaria/ angioedema type reactions in response to NSAIDs. The Kalyoncu classification might be a novel option to classify patients with NSAID hypersensitivity (NH). In this study, we compare the ENDA and the Kalyoncu classifications. Methods: This study enrolled a total of 196 patients. NH reaction types were categorized as asthma, rhinitis, urticaria/angioedema and anaphylaxis. Based on the reaction history and oral provocation test findings, patients were grouped according to ENDA and Kalyoncu classifications. Results: The mean age of the 196 patients was 40.32±13.28 years, and 130 (66.3%) of them were female. Under the ENDA and Kalyoncu classifications, the most common NH subgroups were NERD (32%), and isolated NH (34.2%), the least prevalent NH subgroups were single NSAID-induced delayed reactions (SNIDR) (1.5%), and pseudo Samter’s syndrome (11.7%). Conclusions: Our research revealed that the Kalyoncu classification is more descriptive of patients with NERD exhibiting urticaria/angioedema-type reactions. It also provides future risk assessment for development of NERD. For controversial cases, the Kalyoncu classification can be utilized as a new complimentary option alone or in conjunction with ENDA classification.

Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs in adults

“…A Turkish study reported N-ERD as the most prevalent subgroup (32%) and SNIDR as the least frequent (1.5%), with only two patients (1.0%) not fitting the ENDA criteria. 10 The based on a standardized questionnaire, which may have caused recall bias. The lack of biomarkers based on pathogenic mechanisms, such as urinary Leukotriene E4, serum periostin, and other inflammatory markers, limits our ability to classify these patients and provide new insights into this classification.…”

“…[1][2][3] Developing a comprehensive classification system has been challenging, with multiple classifications proposed in the literature. [4][5][6][7][8][9][10] This diversity in classifications can lead to confusion when interpreting the literature and comparing studies. The latest European Academy of Allergy and Clinical Immunology (EAACI) classification of NSAID hypersensitivity is widely accepted.…”

Cross-hypersensitivity reactions to non-steroidal anti-inflammatory drugs, manifested as urticaria and/or angioedema, anaphylaxis

“…В настоящее время достоверно не известно, является ли ПГЛКА с сопутствующей хронической крапивницей (ПЛГКА+К) отдельным подтипом хронической крапивницы, или обострение хронической крапивницы может развиться у любого пациента с этой патологией на фоне приёма НПВП [6]. Отмечено, что ЛГ к НПВП у взрослых пациентов чаще развивается у женщин [7,8], а в детской популяции -у мальчиков [9,10]. Основные причинно-значимые НПВП -ацетилсалициловая кислота, производные пропионовой кислоты и метамизол натрия [11][12][13].…”