ArticleThe journal of allergy and clinical immunology. In practice2022
Safety, Outcomes, and Recommendations for Two-Step Outpatient Nonsteroidal Anti-Inflammatory Drug Challenges.
Article in The journal of allergy and clinical immunology. In practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 28 citations in OpenAlex.
- Article
- Prescriptions of biologics in patients with chronic rhinosinusitis with nasal polyps in Germany (2019-2023).European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Allergy to acetylsalicylic acid among patients with acute coronary syndrome.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Updating the classification and routine diagnosis of NSAID hypersensitivity reactions: A WAO Statement.The World Allergy Organization journal · 2025Review
- How to Define and Manage Low-Risk Drug Allergy Labels.The journal of allergy and clinical immunology. In practice · 2024Review
- Nonsteroidal anti-inflammatory drug "allergy" labeling is associated with increased postpartum opioid utilization.The Journal of allergy and clinical immunology · 2024Article
- An Update on Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria.Endocrine, metabolic & immune disorders drug targets · 2024Review
- Association of Reported Nonsteroidal Anti-Inflammatory Drug (NSAID) Adverse Drug Reactions With Opioid Prescribing After Total Joint Arthroplasty.The journal of allergy and clinical immunology. In practice · 2023Article
- Two-step nonsteroidal anti-inflammatory drug challenges during pregnancy: A case series.The journal of allergy and clinical immunology. In practice · 2023Article
- A multidisciplinary approach to verify and de-label of drug allergic histories in a university hospital in Thailand: a retrospective descriptive study.Journal of pharmaceutical policy and practice · 2023Article
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5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundNonsteroidal anti-inflammatory drug (NSAID) outpatient challenge protocols are not standardized. They vary in clinical practice and can be time- and resource-intensive to perform.
objectiveTo investigate the safety and outcomes of two-step outpatient NSAID challenges to evaluate patients with non-aspirin-exacerbated respiratory disease (AERD)-related NSAID hypersensitivity.
methodsWe conducted a retrospective study of patients with a history of NSAID allergy who underwent outpatient NSAID challenges under allergist supervision. Individuals with AERD were excluded. Patient demographics, NSAID reaction history, and drug challenge details and outcomes were collected.
resultsA total of 249 patients (mean age, 51.6 years; 63.5% female) underwent 262 NSAID challenges. Of these, 224 challenges were negative (85.5%). Thirty challenges resulted in an immediate reaction during the challenge procedure (11.5%) and eight resulted in delayed reactions (3.1%). Three individuals with immediate reactions required treatment with intramuscular epinephrine. Factors associated with a positive NSAID challenge included a prior reaction occurring within 5 years of drug challenge (odds ratio [OR] = 3.66; 95% confidence interval [CI], 1.67-8.44), a prior immediate reaction within 3 hours of NSAID ingestion (OR = 2.45; 95% CI, 1.12-5.57), a history of cross-reactive NSAID hypersensitivity to multiple NSAIDs (OR = 2.97; 95% CI, 1.23-6.91), and the presence of comorbid chronic spontaneous urticaria (OR = 2.95; 95% CI, 1.35-6.41).
conclusionsMore than 85% of two-step non-AERD NSAID drug challenges were negative for an immediate or delayed reaction, which allowed patients to use at least one clinically indicated NSAID. Challenge reactions were generally mild. Two-step NSAID challenge protocols can be safely performed in the outpatient setting.
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