%0 Journal Article
%T Oral Provocation Test in Non-Steroidal Anti-Inflammatory Drug Hypersensitive Patients Referred to Singapore General Hospital
%A Chaw Su Naing
%A Yong Yeow Chong
%J Open Access Library Journal
%V 4
%N 3
%P 1-7
%@ 2333-9721
%D 2017
%I Open Access Library
%R 10.4236/oalib.1103435
%X
Introduction: Non-steroidal anti-inflammatory drugs
(NSAIDs) are frequently prescribed classes
of drugs and are easily accessible as over-the-counter anti-inflammatory drugs in Singapore. NSAIDs hypersensitivity
is the second most common referral to allergy clinic in a tertiary referral
centre. Methods: Referred patients with history of NSAID intolerance were underwent
open challenge with 1) putative NSAID to confirm the diagnosis; 2) Aspirin to
determine the cross-reactivity or 3) selective cyclooxygenase-2 (COX-2)
inhibitor to identify the suitable alternative. Data were analysed
retrospectively. Results: Over a 4-year period (2010-2014), a total of 127
patients (mean age SD 40.7 /- 15.2) underwent a total of
155 open-labelled labelled NSAIDs oral provocation tests (OPT). Overall
positive challenge rate is 26.5% (41 out of 155). Despite having a clinical relevant
history of causative, only 29.4% (20 out of 68) had positive OPT to putative
NSAIDs. Using selective COX-2 inhibitor challenge for assessing the
tolerability of suitable alternative, we found only 8.8% (5 out of 57) positive
challenge. Conclusions: In our 4-year patients cohort with history of NSAIDs of
intolerance, positive OPT rate of 26.5% in confirming diagnosis of NSAIDs
hypersensitivity. The intolerance to selective COX-2 inhibitor was found in
8.8% of patients with non-steroidal anti-inflammatory drugs hypersensitivity
patients.
%K Non-Steroidal
%K Anti-Inflammatory Drugs
%K Hypersensitivity
%K Cyclooxygenase 2
%U http://www.oalib.com/paper/5282655