Hypersensitivity to Aspirin and Non-Steroidal Antiinflammatory Drugs

Szczeklik, Andrzej; Niżankowska‐Mogilnicka, Ewa; Sanak, Marek

doi:10.1016/b978-0-323-05659-5.00069-3

Cited by 50 publications

(71 citation statements)

References 180 publications

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“…It has been proposed that in AERD patients, deprivation of PGE2 may lead to activation of inflammatory pathways, including increased local and systemic generation of cysteinyl leucotrienes. However, abnormalities in the lipoxygenase pathway of arachidonic acid (AA) metabolism (increased levels of urinary leucotrienes and upregulation of LTC 4 synthase or cysteinyl LT receptors in the airway tissue) are present at baseline as well (2). Several genetic polymorphisms (most related to AA metabolism pathway enzymes) have been associated with AERD.…”

Section: Pathomechanismsmentioning

confidence: 99%

“…Depending on the timing, symptomatology and putative mechanism of the reactions, several subtypes of hypersensitivity to NSAIDs have been distinguished (2,3) (Table 1). In addition, some patients present mixed or blended reactions, which do not fall clearly into any of the proposed categories.…”

Section: Definition and Classificationmentioning

confidence: 99%

“…A typical patient with AERD is a 30-to 40-year-old woman with a history of asthma and/or chronic rhinosinusitis complicated by recurrent nasal polyps (2,18,21). Patients hypersensitive to aspirin suffer from persistent asthma of greater than average severity and of higher than ordinary medication requirements, including dependence on corticosteroids.…”

Section: Underlying Diseasesmentioning

confidence: 99%

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Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Kowalski

Makowska

Blanca³

et al. 2011

Allergy

393

366

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Following the first description of hypersensitivity reaction to aspirin (ASA) by Hirschberg in 1902, several types of hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) have been described. The NSAIDs-induced hypersensitivity reactions involve different mechanisms and present a wide range of clinical manifestations from anaphylaxis AbstractNonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21-25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hypersensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/ or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs.

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Section: Pathomechanismsmentioning

confidence: 99%

Section: Definition and Classificationmentioning

confidence: 99%

Section: Underlying Diseasesmentioning

confidence: 99%

See 1 more Smart Citation

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Kowalski

Makowska

Blanca³

et al. 2011

Allergy

393

366

View full text Add to dashboard Cite

show abstract

“…In a recent Japanese study, patients with multiple exacerbations of asthma more frequently had hypersensitivity to aspirin and reported more asthma-related hospitalizations. Aspirin hypersensitivity was also strongly associated with near-fatal asthma [10].…”

Section: Prevalence Natural History and Clinical Presentationmentioning

confidence: 99%

“…Perhaps a persistent, latent rhinovirus infection of the respiratory tract may be the origin of these alterations in arachidonate metabolism [6,13]. These concepts have been recently reviewed [10,11].…”

Section: Mechanisms Of the Diseasementioning

confidence: 99%

Aspirin-induced asthma: a tribute to John Vane as a source of inspiration

Szczeklik

2010

Pharmacological Reports

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Abstract:Aspirin-induced asthma is a distinct clinical syndrome consisting of inflammation, characterized by chronic eosinophilic rhinosinusitis with asthma and often nasal polyposis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) exacerbate asthma, resulting in violent attacks. This is the hallmark of the clinical syndrome as explained by the cyclooxygenase theory. This theory, which is now generally accepted, states that asthma attacks precipitated by aspirin and other NSAIDs have no allergic background; instead, they occur due to the inhibition of cyclooxygenase-1 in sensitive patients. This paper describes how the discoveries of John Vane inspired the authors of the cyclooxygenase theory and led to further insight into the biology of eicosanoid metabolism in this relatively common type of asthma.

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Safety of Aspirin Desensitization in Patients With Reported Aspirin Allergy and Cardiovascular Disease

McMullan

Wedner

2012

Clinical Cardiology

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Background: Aspirin (ASA) is the drug of choice in patients with coronary artery disease for primary and secondary prevention. This poses a problem for those patients reporting hypersensitivity to this drug or class of drugs. Hypothesis: Desensitization to ASA may be carried out safely and effectively in patients with reported ASA or nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity needing ASA for cardiac indications. Our 7-step protocol is one choice for a rapid desensitization protocol. Methods: A retrospective chart review was conducted evaluating ASA desensitization in patients with reported ASA or NSAID hypersensitivity and a cardiac indication for ASA. Results: In 160 evaluations over 15 years, 89 desensitizations were performed in both the inpatient and outpatient setting with only 16 reactions (18%). Eleven of these 16 patients (68.7%) were able to take daily ASA. Twenty-six desensitization procedures were performed with our 7-step rapid desensitization protocol in 10 inpatients and 16 outpatients with 3 reactions (18.75% of reactions). Initial reaction to ASA involving angioedema and reacting to ASA within the past year increased the risk of having a reaction to desensitization. Conclusions: Desensitization may be safely performed in patients with reported ASA or NSAID hypersensitivity and a cardiac indication for ASA. Our 7-step rapid protocol may be used in both the inpatient and outpatient setting to desensitize these patients. Patients who had angioedema with ASA ingestion or a reaction to ASA within the past year are at higher risk for reaction during the desensitization protocol.

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Hypersensitivity to Aspirin and Non-Steroidal Antiinflammatory Drugs

Cited by 50 publications

References 180 publications

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Aspirin-induced asthma: a tribute to John Vane as a source of inspiration

Safety of Aspirin Desensitization in Patients With Reported Aspirin Allergy and Cardiovascular Disease

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