Non Steroids Anti-inflammatory Drugs (NSAIDs) Intolerance Versus Allergy: Patterns of Response and Drug Involved

Characteristics of subjects experiencing hypersensitivity to non-steroidal anti-inflammatory drugs: patterns of response

“…Early studies of NSAID hypersensitivity reactions due to CI focused on respiratory airway involvement, including asthma and/or rhinitis and nasal polyposis [7,25], though urticaria and anaphylaxis were also reported [2,9,10,26,27]. Over the years, anaphylactic reactions have frequently been reported in the emergency services [27].…”

“…The great world‐wide use of NSAIDs [18] has resulted in this group of drugs being responsible for many adverse drug effects, including hypersensitivity reactions [1, 19]. In addition to aspirin, other NSAIDs, such as ibuprofen, are now taking on a predominant role [10, 19]. Here, we describe the drugs involved in reactions induced by NSAIDs over a consecutive period of 30 years, divided into three decades (Fig.…”

“…Although respiratory symptoms can be accompanied by cutaneous manifestations, especially in the more severe cases, cutaneous manifestations alone in the absence of respiratory involvement induced by different NSAIDs also exist. Surveys and clinical evidence indicate that urticaria is a common problem [10]; NSAIDs not only re‐aggravate pre‐existing urticaria but they can also induce urticaria and/or angio‐oedema as the sole manifestation in subjects with no history of pre‐existing urticaria in a significant number of cases [10].…”

Hypersensitivity Reactions and Acute Hepatitis Induced by Therapeutic Doses of Ibuprofen

“…Non-steroidal anti-inflammatory drugs NSAIDs are the most important group of drugs involved in hypersensitivity drug reactions [4], and include heterogeneous compounds with very different chemical structures. These reactions can be IgE dependent (immediate reactions), T cell-mediated (nonimmediate), or induced by a non-specific immunological mechanism related with the blocking of the COX-1 enzyme and the shunting to the lipooxygenase pathway (cross-intolerant reactions) [4].…”

“…Non-steroidal anti-inflammatory drugs NSAIDs are the most important group of drugs involved in hypersensitivity drug reactions [4], and include heterogeneous compounds with very different chemical structures. These reactions can be IgE dependent (immediate reactions), T cell-mediated (nonimmediate), or induced by a non-specific immunological mechanism related with the blocking of the COX-1 enzyme and the shunting to the lipooxygenase pathway (cross-intolerant reactions) [4]. Cutaneous symptoms are the most frequent, with ibuprofen, naproxen and diclofenac being common culprit drugs worldwide, although others can be involved because patterns of consumption and exposure rates vary between countries [5][6][7].…”