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                <title xml:lang="en">Anaphylaxis to non-opioid analgesics, antipyretics and non-steroidal anti-inflammatory drugs: Analysis of the cases reported to the French Allergy-Vigilance Network from 2002 to 2020</title>
                <title xml:lang="fr">Anaphylaxie aux antalgiques, antipyrétiques et anti-inflammatoires non stéroïdiens : analyse des cas déclarés au Réseau d’Allergo-Vigilance de 2002 à 2020</title>
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                <term xml:lang="en">Pharmacovigilance</term>
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                <term xml:lang="en">Non-steroidal anti-inflammatory drugs (NSAIDs)</term>
                <term xml:lang="en">Non-opioid analgesics</term>
                <term xml:lang="en">Antipyretics</term>
                <term xml:lang="en">Anaphylaxis</term>
                <term xml:lang="fr">Pharmacovigilance</term>
                <term xml:lang="fr">Réseau d’Allergo-Vigilance</term>
                <term xml:lang="fr">Antipyrétiques</term>
                <term xml:lang="fr">Anti-inflammatoires non stéroïdiens (AINS)</term>
                <term xml:lang="fr">Anaphylaxie Antalgiques non-opiacés</term>
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              <p>Non-opioid analgesics, antipyretics and non-steroidal anti-inflammatory drugs are the second cause of drug hypersensitivity and a major cause of drug-induced anaphylaxis. In this retrospective study, we analyzed epidemiological, demographic and clinical characteristics of the cases of anaphylaxis inducedby these drugs and collected by the French Allergy-Vigilance Network (RAV) from 2002 to 2020 and compared our results with those of Pharmacovigilance, French and international data. One hundred and fourteen cases were collected. This number is very low, as compared with the French Pharmacovigilance data (1498), due to a low number of allergists who reported these cases to the RAV. Although the documentation of cases was not homogeneous (patient’s medical history, risk factors, allergological work-up), our results are nearly similar to those of the French and international data. They confirm that these drugs are the second cause of drug-induced anaphylaxis, often secondary to self-medication with paracetamol and ibuprofen. They also confirm that hypersensitivity to these drugs is more frequent in adults than in children, that a personal atopy is a risk factor for allergic hypersensitivity, and that anaphylactic reactions are undertreated (underuse of epinephrine). They also suggest that reactions due to allergic hypersensitivity are more frequent in children than in adults. Finally, our results confirm that the diagnostic value of skin tests, specific IgE determinations and basophil activation tests is low, and that diagnosis of HS to these drugs is mainly based on a suggestive clinical history and/or provocation tests.</p>
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              <p>Les antalgiques, antipyrétiques, anti-inflammatoires non stéroïdiens représentent la seconde cause d’hypersensibilité présumée et prouvée aux médicaments et une importante cause d’anaphylaxie médicamenteuse. Le but de cette étude rétrospective a été d’analyser les caractéristiques épidémiologiques, démographiques et cliniques des cas d’anaphylaxie à ces médicaments déclarés au Réseau français d’Allergo-Vigilance entre 2002 et 2020, et de les comparer aux données correspondantes de la pharmacovigilance française et de la littérature nationale et internationale. Cent-quatorze déclarations ont été recensées, un nombre très faible par rapport aux déclarations en pharmacovigilance (1498), du fait d’un nombre faible et variable de déclarants. Malgré le caractère inhomogène des déclarations (antécédents des patients, facteurs de risque et facteurs favorisants, modalités des bilans) et le faible nombre de déclarations, nos résultats sont sensiblement identiques à ceux des publications nationales et internationales en confirmant que ces médicaments sont la 2e cause d’anaphylaxie médicamenteuse, faisant souvent suite à une automédication, notamment par le paracétamol et l’ibuprofène. Ils confirment aussi l’influence de l’âge (adultes &amp;gt; enfants) et qu’une atopie personnelle représente un facteur de risque d’hypersensibilité allergique, ainsi qu’une prise en charge initiale sous-optimale, notamment en ce qui concerne l’usage de l’adrénaline. Ils suggèrent que, chez l’enfant, les réactions d’hypersensibilité allergique seraient plus fréquentes que chez les adultes, chez lesquels prédominent les hypersensibilités non allergiques. Enfin, ils confirment que le diagnostic repose essentiellement sur une histoire clinique évocatrice et/ou sur les tests de provocation, les tests cutanés, les dosages d’IgE sériques spécifiques et les tests d’activation des basophiles ayant une faible valeur diagnostique.</p>
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