Respiratory hypersensitivity reactions to NSAIDs in Europe: the global allergy and asthma network (GA2 LEN) survey

Allergy. 2016 Nov;71(11):1603-1611. doi: 10.1111/all.12941. Epub 2016 Jul 11.

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most prevalent drugs inducing hypersensitivity reactions. The aim of this analysis was to estimate the prevalence of NSAID-induced respiratory symptoms in population across Europe and to assess its association with upper and lower respiratory tract disorders.

Methods: The GA2 LEN survey was conducted in 22 centers in 15 European countries. Each of 19 centers selected random samples of 5000 adults aged 15-74 from their general population, and in three centers (Athens, Munich, Oslo), a younger population was sampled. Questionnaires including questions about age, gender, presence of symptoms of asthma, allergic rhinitis, chronic rhinosinusitis, smoking status, and history of NSAID-induced hypersensitivity reactions were sent to participants by mail. Totally, 62 737 participants completed the questionnaires.

Results: The mean prevalence of NSAID-induced dyspnea was 1.9% and was highest in the three Polish centers [Katowice (4.9%), Krakow (4.8%), and Lodz (4.4%)] and lowest in Skopje, (0.9%), Amsterdam (1.1%), and Umea (1.2%). In multivariate analysis, the prevalence of respiratory reactions to NSAIDs was higher in participants with chronic rhinosinusitis symptoms (Odds Ratio 2.12; 95%CI 1.78-2.74), asthma symptoms in last 12 months (2.7; 2.18-3.35), hospitalization due to asthma (1.53; 1.22-1.99), and adults vs children (1.53; 1.24-1.89), but was not associated with allergic rhinitis.

Conclusion: Our study documented significant variation between European countries in the prevalence of NSAID-induced respiratory hypersensitivity reactions, and association with chronic airway diseases, but also with environmental factors.

Keywords: GA2LEN; NSAIDs hypersensitivity; drug allergy; epidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Comorbidity
  • Cross-Sectional Studies
  • Drug Hypersensitivity / epidemiology*
  • Drug Hypersensitivity / etiology*
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance
  • Prevalence
  • Respiratory Hypersensitivity / diagnosis
  • Respiratory Hypersensitivity / epidemiology*
  • Respiratory Hypersensitivity / etiology*
  • Risk Factors
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal