A new classification option for NSAID hypersensitivity: Kalyoncu classification.

Area of Science:

• Pharmacology
• Clinical Immunology
• Allergy

Background:

• The European Network for Drug Allergy (ENDA) established guidelines for NSAID hypersensitivity (NH) in 2011.
• A subset of patients with NSAIDs-exacerbated respiratory disease (NERD) exhibit urticaria/angioedema upon NSAID exposure.
• The Kalyoncu classification presents a potential new method for categorizing NH patients.

Purpose of the Study:

• To compare the efficacy of the ENDA and Kalyoncu classifications in categorizing patients with NSAID hypersensitivity (NH).
• To evaluate the Kalyoncu classification's descriptiveness for patients with NSAIDs-exacerbated respiratory disease (NERD) and urticaria/angioedema reactions.

Main Methods:

• 196 patients with NH reactions (asthma, rhinitis, urticaria/angioedema, anaphylaxis) were enrolled.
• Patients were classified using both ENDA and Kalyoncu criteria based on reaction history and oral provocation tests.

Main Results:

• The most common NH subgroups identified were isolated NH (34.2%) and NERD (32%) under both classifications.
• Single NSAID-induced delayed reactions (SNIDR) (1.5%) and pseudo Samter's syndrome (11.7%) were the least prevalent subgroups.
• The Kalyoncu classification proved more descriptive for NERD patients with urticaria/angioedema.

Conclusions:

• The Kalyoncu classification offers a more detailed description for NERD patients experiencing urticaria/angioedema.
• It may aid in assessing future risks for developing NERD.
• The Kalyoncu classification can serve as a complementary tool alongside ENDA for complex NH cases.