Negative Tests Highly Predictive of No NSAID Allergy

Negative predictive value of hypersensitivity provocation tests with NSAIDs is high

MONDAY, July 18 (HealthDay News) -- The negative predictive value (NPV) of provocation tests for hypersensitivity with nonsteroidal anti-inflammatory drugs (NSAIDs) is high, with none of the patients with a false negative test reporting a life threatening reaction, according to a study published online July 4 in Allergy.

C. Defrance, from the University Hospital of Montpellier in France, and colleagues investigated the NPV of provocation tests with NSAIDs. A total of 393 patients who had a clinical suspicion of hypersensitivity and a negative provocation test for NSAIDs between 2005 and 2009 were evaluated and 279 were available for follow-up six months later. A new provocation test was conducted in patients who reported a hypersensitivity reaction with a particular NSAID. The participants were followed up for an average of 33 months.

The investigators found that 260 participants took an NSAID at least once. A total of 139 took the same NSAID as the one tested, 215 took an alternative, and 94 took both the tested NSAID and an alternative. A reaction occurred immediately after the first NSAID administration in eight patients; none of the reactions were severe. Of these, five patients had tested negative for the NSAID, giving an NPV of 97.8 percent; three underwent re-challenge, and one tested positive. Three patients reacted to an alternative NSAID representing an NPV of 98.6 percent.

"The NPV of drug provocation tests with NSAIDs is high (over 96 percent) whatever the NSAID (the one negatively tested or an alternative), and none of the false-negative patients described a life-threatening reaction," the authors write.

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