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首页> 外文期刊>Allergy >Evaluating the negative predictive value of provocation tests with nonsteroidal anti-inflammatory drugs.
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Evaluating the negative predictive value of provocation tests with nonsteroidal anti-inflammatory drugs.

机译：用非甾体类抗炎药评估激发试验的阴性预测价值。

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BACKGROUND: The nonsteroidal anti-inflammatory drugs (NSAIDs) hypersensitivity work-up is based on clinical history, skin tests, and drug provocation tests. The negative predictive value (NPV) of the latter is not established. METHOD: A cohort study was conducted in the Allergy Department in Montpellier to evaluate the NPV of the provocation test with NSAIDs in patients with clinical presentation suggestive of hypersensitivity, and negatively tested. Patients were contacted at least 6 months after the work-up. Patients who took NSAID and reacted were proposed a new allergy work-up, which included a provocation test with the culprit drug. RESULTS: Among the 393 patients contacted, 279 (71.0%) were followed up. Two hundred and sixty (93.2%) patients had taken a NSAID at least once: 139 (53.5%) the same drug as the one tested and 215 (82.7%) an alternative (94, 33.7% taking both the tested NSAID and an alternative). Eight patients (3.1%) reported a reaction (five with the negatively tested NSAID and three with another NSAID). All the reactions occurred immediately after the first administration and were not severe. Among the five patients who reacted with the negatively tested NSAID, only three accepted a re-challenge, negative in two cases and positive in one, representing a NPV of 97.8% (95% CI: 95.4-100%). Three patients (3/215) reported a reaction when an alternative NSAID was taken, representing a NPV of 98.6% (95% CI: 97-100%). CONCLUSION: The NPV of NSAIDs drug provocation test is high. This should reassure physicians who might hesitate to prescribe NSAIDs, especially in patients with negative allergic work-ups.
机译：背景：非甾体类抗炎药（NSAIDs）超敏反应的检查基于临床病史，皮肤试验和药物激发试验。后者的阴性预测值（NPV）未建立。方法：在蒙彼利埃过敏科进行了一项队列研究，以NSAIDs评估临床表现提示超敏反应的患者的激发试验的NPV，并进行了阴性测试。在检查后至少六个月与患者联系。服用NSAID并有反应的患者被提议进行新的过敏检查，其中包括对罪魁祸首药物的激发试验。结果：在所接触的393例患者中，有279例（71.0％）得到了随访。 260名（93.2％）的患者至少服用过一次NSAID：139（53.5％）的药物与被测药物相同，另215（82.7％）的替代药物（94、33.7％的人同时接受了NSAID和另一种药物治疗） ）。 8位患者（3.1％）报告了反应（5位接受阴性测试的NSAID，3位接受另一种NSAID）。第一次给药后立即发生所有反应，反应不严重。在接受阴性测试的NSAID发生反应的五名患者中，只有三名接受了再次挑战，两名患者为阴性，其中一名为阳性，代表NPV为97.8％（95％CI：95.4-100％）。三名患者（3/215）报告称，服用另一种NSAID时有反应，NPV为98.6％（95％CI：97-100％）。结论：NSAIDs药物激发试验的NPV较高。这应该使医师放心，他们可能会犹豫开出NSAID，特别是在过敏检查阴性的患者中。

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