hypersensitivity; however, only few data about follow-up of patients with negative DPTs are actually available. The aim of this
study was to assess patients’ behavior in taking NSAIDs again and to evaluate NSAID tolerability after negative allergological
workup.
Methods: This is a follow-up study involving patients evaluated for history of cutaneous reactions (urticaria and or angioedema)
after NSAID intake and with negative DPTs with the suspected NSAID. Patients were asked during a phone interview about
the intake of NSAIDs, tolerance, or reasons of avoidance. The negative predictive value (NPV) of NSAIDs DPTs was
calculated.
Results: One hundred eleven of 142 patients were successfully contacted; 46/111 (41.44%) took the same NSAID previously
tested with two adverse reactions reported (4.34%). Fifty-three of 111 (47.74%) patients did not take the same NSAID, but 34
of them took at least another strong cyclooxygenase (COX) 1 inhibitor, with 1 adverse reaction (2.94%) and 19 of them took
only weak COX-1 inhibitors. Twelve of 111 patients (10.8%) did not take any NSAID. Reasons for drug avoidance were mainly
fear of reactions (70.8%) and no need (29.2%). NPV, overall, was 96.97% (95% confidence interval, 91–99%).
Conclusions: Although NSAID hypersensitivity diagnosis was ruled out by oral provocation test, the majority of patients with a history of
urticaria/angioedema avoided the intake of the tested NSAIDs for fear of new reactions, particularly when strong COX-1
inhibitor NSAIDs were involved. The high NPV value of DPT resulting from this study should reassure NSAID intake.