Different Patterns of Response in Hypersensitivity Reactions to Arylpropionic Acid Derivatives

Area of Science:

• Pharmacology
• Immunology
• Dermatology

Background:

• Arylpropionic acid derivatives (APs), including ibuprofen, are widely used NSAIDs.
• Drug hypersensitivity reactions (DHRs) to APs are not well understood.
• This study investigates DHRs in patients exposed to APs.

Purpose of the Study:

• To comprehensively characterize patients experiencing DHRs to APs.
• To analyze clinical presentations, reaction patterns, and diagnostic methods for AP-DHRs.
• To differentiate between cross-reactive (CRs) and selective reactions (SRs).

Main Methods:

• Prospective evaluation of patients with suspected AP-DHRs.
• Analysis of clinical characteristics, reported reactions, and diagnostic test results.
• Inclusion of 662 patients confirmed as hypersensitive to APs.

Main Results:

• 662 patients were included: 73.86% with CRs and 26.13% with SRs.
• Ibuprofen and dexketoprofen were more frequent in CRs; naproxen and ketoprofen in SRs.
• Angioedema and urticaria were the most common symptoms; nasal provocation tests were often positive.

Conclusions:

• The skin is the most affected organ in AP-DHRs.
• Ibuprofen and dexketoprofen are frequently implicated in CRs, while naproxen and ketoprofen are linked to SRs.
• Further research is needed to elucidate the mechanisms of AP-induced DHRs.