ArticleFrontiers in allergy2025
Labeled NSAID hypersensitivity and the risk of opioid prescribing; an observational study.
Article in Frontiers in allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: NSAIDs are widely used for pain management but are second only to antibiotics in causing drug hypersensitivity reactions. Misclassification of these reactions often leads to unnecessary avoidance of the entire drug class, potentially resulting in increased opioid prescribing. This study aimed to assess the prevalence and characteristics of NSAID hypersensitivity, cross-reactivity patterns, and the association between NSAID hypersensitivity and opioid prescribing. The use of COX-2 selective inhibitors as a safe alternative was also explored. Methods: A retrospective cohort study was conducted at a tertiary care hospital, including patients with documented NSAID hypersensitivity between 2016 and 2023. Data on demographics, hypersensitivity reactions, NSAID cross-reactivity, and opioid prescriptions were collected. Patients with penicillin hypersensitivity were included for comparison. Logistic regression was used to analyze the association between NSAID hypersensitivity and opioid prescribing. Results: Among 319 patients with NSAID hypersensitivity, 30% ( Conclusion: NSAID hypersensitivity is associated with increased opioid prescribing due to class-wide avoidance. Despite concerns about cross-reactivity, many patients can tolerate alternative NSAIDs. Improved classification tools and clinical decision support systems are needed to guide prescribers.
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