Time for more clinical research on non-steroidal anti-inflammatory drug-induced urticaria/angioedema and anaphylaxis

摘要

Acetylsalicylic acid (ASS, aspirin) and other non-steroi-dal anti-inflammatory drugs (NSAID) are commonly used all over the world. NSAID have been reported to be the cause of 20-25% of all adverse drug reactions and are together with beta-lactams the most frequent elicitors of drug hypersensitivity reactions . NSAID hypersensitivity is classified nowadays according to clinical characteristics (respiratory disease, urticaria/an-gioedema, anaphylaxis and exanthema), the presence of underlying diseases (chronic urticaria, bronchial asthma) and the presence of cross-reactivity to other structurally non-related strong inhibitors of the enzyme cyclooxygenase 1 (Cox 11) (single or cross-intolerant) (Table 1). In NSAID hypersensitivity, urticaria and an-gioedema are the most frequent clinical manifestations. However, whereas a multitude of studies on the mechanism have been performed in patients with 'aspirin-exacerbated respiratory disease' (AERD, formerly called aspirin-induced asthma), the number of studies about and study groups working on cutaneous hypersensitivity reactions to NSAID urticaria, angioedema and on anaphylaxis is scarce (reviewed in [4]).