全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

Oral Provocation Test in Non-Steroidal Anti-Inflammatory Drug Hypersensitive Patients Referred to Singapore General Hospital

DOI: 10.4236/oalib.1103435, PP. 1-7

Subject Areas: Allergy & Clinical Immunology

Keywords: Non-Steroidal, Anti-Inflammatory Drugs, Hypersensitivity, Cyclooxygenase 2

Full-Text   Cite this paper   Add to My Lib

Abstract

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed classes of drugs and are easily accessible as over-the-counter anti-inflammatory drugs in Singapore. NSAIDs hypersensitivity is the second most common referral to allergy clinic in a tertiary referral centre. Methods: Referred patients with history of NSAID intolerance were underwent open challenge with 1) putative NSAID to confirm the diagnosis; 2) Aspirin to determine the cross-reactivity or 3) selective cyclooxygenase-2 (COX-2) inhibitor to identify the suitable alternative. Data were analysed retrospectively. Results: Over a 4-year period (2010-2014), a total of 127 patients (mean age SD 40.7 /- 15.2) underwent a total of 155 open-labelled labelled NSAIDs oral provocation tests (OPT). Overall positive challenge rate is 26.5% (41 out of 155). Despite having a clinical relevant history of causative, only 29.4% (20 out of 68) had positive OPT to putative NSAIDs. Using selective COX-2 inhibitor challenge for assessing the tolerability of suitable alternative, we found only 8.8% (5 out of 57) positive challenge. Conclusions: In our 4-year patients cohort with history of NSAIDs of intolerance, positive OPT rate of 26.5% in confirming diagnosis of NSAIDs hypersensitivity. The intolerance to selective COX-2 inhibitor was found in 8.8% of patients with non-steroidal anti-inflammatory drugs hypersensitivity patients.

Cite this paper

Naing, C. S. and Chong, Y. Y. (2017). Oral Provocation Test in Non-Steroidal Anti-Inflammatory Drug Hypersensitive Patients Referred to Singapore General Hospital. Open Access Library Journal, 4, e3435. doi: http://dx.doi.org/10.4236/oalib.1103435.

References

[1]  Gomes, E., Cardoso, M.F., Praca, F., Gomes, L., Marino, E. and Demoly, P. (2004) Self-Reported Drug Allergy in a General Adult Portuguese Population. Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology, 34, 1597-1601.
https://doi.org/10.1111/j.1365-2222.2004.02070.x
[2]  Nissen, C.V., Bindslev-Jensen, C. and Mortz, C.G. (2015) Hypersensitivity to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Classification of a Danish Patient Cohort According to EAACI/ENDA Guidelines. Clinical and Translational Allergy, 5, 10.
https://doi.org/10.1186/s13601-015-0052-0
[3]  Kowalski, M.L., Asero, R., Bavbek, S., Blanca, M., Blanca-Lopez, N., Bochenek, G., et al. (2013) Classification and Practical Approach to the Diagnosis and Management of Hypersensitivity to Nonsteroidal Anti-Inflammatory Drugs. Allergy, 68, 1219-1232.
https://doi.org/10.1111/all.12260
[4]  Sanchez-Borges, M., Caballero-Fonseca, F., Capriles-Hulett, A. and Gonzalez-Aveledo, L. (2010) Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs: An Update. Pharmaceuticals, 3, 10-18.
https://doi.org/10.3390/ph3010010
[5]  Tan, V.A., Gerez, I.F. and Van Bever, H.P. (2009) Prevalence of Drug Allergy in Singaporean Children. Singapore Medical Journal, 50, 1158-1161.
[6]  Quiralte, J., Blanco, C., Delgado, J., Ortega, N., Alcntara, M., Castillo, R., et al. (2007) Challenge-Based Clinical Patterns of 223 Spanish Patients with Nonsteroidal Anti-Inflammatory-Drug-Induced-Reactions. Journal of Investigational Allergology & Clinical Immunology, 17, 182-188.
[7]  Malskat, W.S., Knulst, A.C., Bruijnzeel-Koomen, C.A. and Rockmann, H. (2013) Tolerance to Alternative Cyclooxygenase-2 Inhibitors in Nonsteroidal Anti-Inflammatory Drug Hypersensitive Patients. Clinical and Translational Allergy, 3, 20.
https://doi.org/10.1186/2045-7022-3-20
[8]  Llanora, G.V., Loo, E.X., Gerez, I.F., Cheng, Y.K. and Shek, L.P. (2013) Etoricoxib: A Safe Alternative for NSAID Intolerance in Asian Patients. Asian Pacific Journal of Allergy and Immunology, 31, 330-333.
https://doi.org/10.12932/AP0290.31.4.2013
[9]  Bavbek, S., Celik, G., Ozer, F., Mungan, D. and Misirligil, Z. (2004) Safety of Selective COX-2 Inhibitors in Aspirin/Nonsteroidal Anti-Inflammatory Drug-Intolerant Patients: Comparison of Nimesulide, Meloxicam, and Rofecoxib. The Journal of Asthma: Official Journal of the Association for the Care of Asthma, 41, 67-75.
https://doi.org/10.1081/JAS-120026063
[10]  Asero, R. and Quaratino, D. (2013) Cutaneous Hypersensitivity to Multiple NSAIDs: Never Take Tolerance to Selective COX-2 Inhibitors (COXIBs) for Granted! European Annals of Allergy and Clinical Immunology, 45, 3-6.
[11]  Kim, Y.-J., Lim, K.-H., Kim, M.-Y., Jo, E.-J., Lee, S.-Y., Lee, S.-E., et al. (2014) Cross-Reactivity to Acetaminophen and Celecoxib According to the Type of Nonsteroidal Anti-Inflammatory Drug Hypersensitivity. Allergy, Asthma & Immunology Research, 6, 156-162.
https://doi.org/10.4168/aair.2014.6.2.156
[12]  Quercia, O., Emiliani, F., Foschi, F.G. and Stefanini, G.F. (2008) Safety of Etoricoxib in Patients with Reactions to NSAIDs. Journal of Investigational Allergology & Clinical Immunology, 18, 163-167.
[13]  Warner, T.D. and Mitchell, J.A. (2004) Cyclooxygenases: New Forms, New Inhibitors, and Lessons from the Clinic. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology, 18, 790-804.
https://doi.org/10.1096/fj.03-0645rev
[14]  Matucci, A., Parronchi, P., Vultaggio, A., Rossi, O., Brugnolo, F., Maggi, E., et al. (2004) Partial Safety of the New COX-2 Inhibitor Rofecoxib in NSAIDs High Sensitive Patients. Allergy, 59, 1133-1134.
https://doi.org/10.1111/j.1398-9995.2004.00532.x

Full-Text


comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133

WeChat 1538708413