Drug Hypersensitivity Clinical Trial
Official title:
Construction and Validation of a Simplified Provocation Tests for the Diagnosis of Non Steroidal Anti-inflammatory Drugs (NSAID) Hypersensitivity
Background : Non steroidal anti-inflammatory drugs are responsible for 25% of reported
adverse drug events which include immunological and non-immunological hypersensitivity
reactions. NSAIDs have been reported to be the second most common cause of drug-induced
hypersensitivity reaction (DHR). They are almost mandatory in a human life and therefore, the
drug allergy work-up goes up until a DPT in order to confirm or rule out the diagnosis.
Objective: Detect eliciting dose thresholds during NSAIDs DPT in order to suggest optimal
step doses and to describe subgroups at higher risk during the DPT
Methods:This retrospective study, using the survival analysis, comprised all patients who
attended the allergy service of the UH of Montpellier from 1997 till 2017 with a clinical
history related to NSAIDs DHR, who underwent NDAIDs DPT that turned positive and who gave
their consent to be included in the study . The Patients are selected from the Drug Allergy &
Hypersensitivity Database (DAHD).
DHRs to NSAIDs may be induced by both specific immunological mechanisms and mechanisms not
based on immunological recognition (cross-hypersensitivity reactions [CRs]) .They are almost
mandatory in a human life and therefore, the drug allergy work-up goes up until a DPT in
order to confirm or rule out the diagnosis. Although the overall prevalence of NSAID
hypersensitivity has been reported between 0.6 and 7% of the general population .
The NSAIDs‐induced hypersensitivity reactions involve different mechanisms and present a wide
range of clinical manifestations from anaphylaxis or severe bronchospasm developing within
minutes after drug ingestion to non-immediate responses appearing after days and weeks This
data-driven approach in designing the DPT protocol is the second step in improving DPT
standardization, after BL antibiotics.
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