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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Safety of 5-AminosaIicyIic Acid Derivatives in Patients with Sensitivity to Acetylsalicylic Acid and Nonsteroidal Anti-inflammatory Drugs
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Safety of 5-AminosaIicyIic Acid Derivatives in Patients with Sensitivity to Acetylsalicylic Acid and Nonsteroidal Anti-inflammatory Drugs

机译：5-氨基水杨酸衍生物对乙酰水杨酸和非甾体类抗炎药敏感的患者的安全性

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Background: One of the cornerstones of the management of inflammatory bowel disease is the use of 5-aminosalicylic acid (5-ASA) compounds for treatment of flares and as maintenance therapy during remission. There are concerns about using 5-ASA in patients with a history of hypersensitivity to acetylsalicylic acid (ASA).Objective: To assess the literature with respect to the safety of 5-ASA compounds in patients with documented sensitivity to ASA or nonsteroidal anti-inflammatory drugs (NSAIDs).Data Sources: A literature search was conducted in the MEDLINE and Embase databases, using various search terms, including "aminosalicylic acids", "non-steroidal anti-inflammatory agents," "hypersensitivity", and "allergy". The search was limited to articles (of any study design) published in English. Abstracts, full articles, and reference lists from retrieved articles were assessed to identify further relevant literature.Study Selection and Data Extraction: Of 485 citations identified in the initial search, 4 case reports were relevant to the study objective and were analyzed in detail.Data Synthesis: Three of the case reports described the successful use of 5-ASA compounds in patients with prior sensitivity to ASA or an NSAID. The fourth report described a reaction to 5-ASA in a patient who had previously tolerated ASA. All of tlie reports were limited by lack of investigation into the validity of the reported sensitivity to ASA or 5-ASA.Conclusions: There is a dearth of evidence demonstrating cross-reactivity between ASA or NSAID and 5-ASA. This lack of information may relate to the mechanism of action of 5-ASA. This agent controls inflammation by inhibiting prostaglandin E2 and leukotrienes. In contrast, ASA-induced or NSAID-induced reactions are due to inhibition of the cycloxygenase-1 enzyme and subsequent release of histamine and synthesis of leukotrienes. Further reports describing the safety of 5-ASA use in patients with sensitivity to ASA or NSAIDs are needed before safety in this situation can be definitively determined. In patients with sensitivity to ASA or NSAID who require 5-ASA, a test dose of 5-ASA (to rule out potential cross-reactivity) or further investigation of the ASA or NSAID sensitivity is recommended.
机译：背景：炎性肠病治疗的基石之一是使用5-氨基水杨酸（5-ASA）化合物治疗耀斑并在缓解期间作为维持疗法。对于对乙酰水杨酸（ASA）过敏的患者有使用5-ASA的担忧。目的：评估文献中对ASA或非甾体类抗炎药敏感的患者中5-ASA化合物安全性的文献数据来源：在MEDLINE和Embase数据库中进行了文献检索，使用了各种检索词，包括“氨基水杨酸”，“非甾体类抗炎药”，“超敏性”和“过敏”。该搜索仅限于以英语发表的（任何研究设计的）文章。研究选择和数据提取：在最初检索的485篇文献中，有4篇与研究目标相关的病例报告已被详细分析。综述：3例病例报告描述了在对ASA或NSAID有先验敏感性的患者中成功使用5-ASA化合物。第四份报告描述了先前耐受ASA的患者对5-ASA的反应。由于缺乏对所报道的对ASA或5-ASA敏感性的有效性的调查，所有的报道都受到限制。结论：缺乏证据表明ASA或NSAID与5-ASA之间存在交叉反应。信息的缺乏可能与5-ASA的作用机制有关。该药物通过抑制前列腺素E2和白三烯来控制炎症。相反，ASA诱导或NSAID诱导的反应是由于抑制了环氧合酶1酶和随后的组胺释放以及白三烯的合成。需要进一步的报告描述在对ASA或NSAID敏感的患者中使用5-ASA的安全性，才能确定这种情况下的安全性。对于需要5-ASA的对ASA或NSAID敏感的患者，建议测试剂量为5-ASA（以排除潜在的交叉反应）或进一步研究ASA或NSAID的敏感性。

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