Abstract
In the large majority of previous studies, patients with a history of acute urticaria induced by nonsteroidal anti-inflammatory drugs (NSAIDs) seeking safe alternative drugs have undergone tolerance tests uniquely with compounds exerting little or no inhibitory effect on the cyclooxygenase 1 enzyme. In light of recently published studies, however, this approach seems inadequate and should be changed. The present article critically reviews the clinical management of patients presenting with a history of urticaria induced by a single NSAID or multiple NSAIDs and suggests a simple, updated diagnostic algorithm that may assist clinicians in correctly classifying their patients.
Highlights
In the large majority of previous studies, patients with a history of acute urticaria induced by nonsteroidal anti-inflammatory drugs (NSAIDs) seeking safe alternative drugs have undergone tolerance tests uniquely with compounds exerting little or no inhibitory effect on the cyclooxygenase 1 enzyme
Their question is ‘‘What can I take in case of headache, pain, or fever?’’ The present article focuses on the clinical management of patients with NSAID-induced urticaria/angioedema in view of recently published literature
And to patients with aspirin-exacerbated respiratory disease (AERD), in patients with acute urticaria induced by distinct NSAIDs, cross-reactions occurred mainly among COX-1inhibiting drugs,[13,17] whereas drugs exerting little effect on the cyclooxygenase 1 (COX-1) enzyme[10,11,18,19,20,21,22,23,24] and NSAIDs characterized by different mechanisms of actions or opiate agonists with analgesic activity[9,11,15,25] were generally well tolerated
Summary
Clinical Management of Adult Patients with a History of Nonsteroidal Anti-Inflammatory Drug–Induced Urticaria/ Angioedema: Update. Skin reactions (urticaria/angioedema) are Allergy, Asthma, and Clinical Immunology, Volume 3, Number 1, 2007
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