Résumé
Objectives: DTP remains, in most instances, the sole approach to confirm NSAIDs hypersensitivity. The procedure has an excellent NPV, but a sensitivity calculated mainly for the NSAIDs-exacerbated respiratory disease phenotype. Our objective was to perform an analysis of the sensitivity of DPT for redefined patient groups with suspected NSAIDs-hypersensitivity, using a Drug Allergy and Hypersensitivity Database (DAHD).Method: A retrospective analysis of patients registered in DAHD between 01.02.2001 and 01.12.2020, at the Allergy Unit, University Hospital Montpellier, was carried out. The sensitivity of DPT for different groups was calculated with IBM SPSS Statistics-26.0, using contingency tables.Results: In total, 1739 patients were distributed in six groups based on the number of events, the chemical structure and COX-inhibitory activity of culprit(s) – Groups 1 and 2 with one, respectively multiple events with aspirin (ASA)/aryl-carboxylic acid derivatives (AryCx), Groups 3 and 4 with one and multiple events with UNK/WeakCOX1/COX2 selective inhibitors (weCOX1/COX2) and Groups 5 and 6 with one and multiple events with other nonselective COX-inhibitors. All groups were considered against the DPT with culprit/alternatives from the abovementioned classes. The DPT sensitivity for Group 1 was around 11% for all tested drugs. For Group 2, the DPT sensitivity was around 17% for weCOX1/COX2 and 35% for ASA/AryCx alternative. DPT for Groups 3 and 4 had a sensitivity of around 15% for weCOX1/COX2 culprit. The resulting data were integrated into an algorithm defining four probabilities of hypersensitivity–“excluded”(1/≥2 events with DPT to culprit negative; exception-ASA/AryCx-weCOX1/COX2 reactions provoked to weCOX1/COX2-moved to “UNK probability”), “confirmed”(all patients with positive DPT to culprits), “low probability”(1 event with AryCx/ASA with negative DPT to AryCx/ASA alternatives) and “UNK probability”(five classes with 1/≥2 events and negative DPT to different potency drugs).Conclusions: A probability algorithm for NSAIDs-hypersensitivity has been developed on the calculated DPT sensitivity for different groups.