Statement of the Spanish Society of Allergology and Clinical Immunology on Provocation Tests With Aspirin/Nonsteroidal Anti-inflammatory Drugs

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Publicated to:Journal Of Investigational Allergology And Clinical Immunology. 30 (1): 1-13 - 2020-01-01 30(1), DOI: 10.18176/jiaci.0449

Authors: Izquierdo-Domínguez, A; Bobolea, I; Dona, I; Campo, P; Torres, MJ; Segura, C; Delgado, J; Ortega, N; González, R; Dordal, MT

Affiliations

Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain. - Author

Allergy Section, Servei de Pneumologia i Al.lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain. - Author

Allergy Service, Consorci Sanitari de Terrassa, Barcelona, Spain. - Author

Allergy Service, Hospital Universitario de Canarias, Tenerife, Spain. - Author

Allergy Unit, Clínica Diagonal, Barcelona, Spain. - Author

Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain. - Author

Allergy Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain. - Author

Allergy Unit, Servei de Medicina Interna, Hospital Universitari de Bellvitge, Barcelona, Spain. - Author

Clin Diagonal, Allergy Unit, Barcelona, Spain - Author

Consorci Sanitari Terrassa, Allergy Serv, Barcelona, Spain - Author

Hosp Clin Barcelona, Allergy Sect, Serv Pneumol & Allergia Resp, Barcelona, Spain - Author

Hosp Reg Univ Malaga, Allergy Unit, Malaga, Spain - Author

Hosp Univ Bellvitge, Allergy Unit, Serv Med Interna, Barcelona, Spain - Author

Hosp Univ Canarias, Allergy Serv, Tenerife, Spain - Author

Hosp Univ Gran Canaria Dr Negrin, Allergy Unit, Las Palmas Gran Canaria, Spain - Author

Hosp Univ Virgen Macarena, UGC Alergol, Seville, Spain - Author

Inst Invest Biomed Malaga IBIMA, Allergy Res Grp, Malaga, Spain - Author

NULL - Author

UGC Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain. - Author

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used throughout the world. They are frequently involved in hypersensitivity reactions, which range from local or mild reactions to systemic and severe reactions. Consequently, it is necessary to perform an exhaustive study of patients in order to make an accurate diagnosis, search for safe procedures in the case of severe reactions, and identify alternative treatment options. Various guidelines and protocols address the management of hypersensitivity to NSAIDs, although these vary widely from country to country. The Committees of Asthma, Rhinoconjunctivitis, and Drug Allergy of the Spanish Society of Allergy and Clinical Immunology (SEAIC) propose the present position statement on available options for provocation testing with aspirin/NSAIDs. This document is the fruit of an exhaustive review of current evidence and is based on recent publications addressing the diagnosis of patients with hypersensitivity to NSAIDs and on a consensus-oriented discussion among a group of experts from the SEAIC. The main objective was to draft an easy-toread, practical guideline for health care professionals in specialist areas who assess and manage patients with suspected hypersensitivity to NSAIDs. Furthermore, indications, contraindications, and procedures for oral, bronchial, and nasal provocation tests with aspirin/NSAIDs have been updated.

Keywords

acoustic rhinometryaspirinaspirin provocation testexacerbated respiratory-diseasehypersensitivity reactionsinduced bronchoconstrictionintolerant asthmaleukotriene-modifier drugslysine-acetylsalicylatenasal challengenerdnsaidreceptor expressionAerdAllergensAllergy and immunologyAnti-inflammatory agents, non-steroidalAspirinAspirin provocation testAspirin-induced asthmaDrug hypersensitivityExpert testimonyHumansNasal provocation testsNerdNsaidPractice guidelines as topicSpain

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Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Investigational Allergology And Clinical Immunology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 5/28, thus managing to position itself as a Q1 (Primer Cuartil), in the category Allergy.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 4.34, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-14, the following number of citations:

WoS: 8
Scopus: 17
OpenCitations: 9

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Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Izquierdo Dominguez, Adriana) .

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