title: Respiratory hypersensitivity reactions to NSAIDs in Europe: the global allergy and asthma network (GA2LEN) survey.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most prevalent drugs inducing hypersensitivity reactions. The aim of this analysis was to estimate the prevalence of NSAID-induced respiratory symptoms in population across Europe and to assess its association with upper and lower respiratory tract disorders.
  
  
  
  The GA2LEN survey was conducted in 22 centers in 15 European countries. Each of 19 centers selected random samples of 5000 adults aged 15-74 from their general population, and in three centers (Athens, Munich, Oslo), a younger population was sampled. Questionnaires including questions about age, gender, presence of symptoms of asthma, allergic rhinitis, chronic rhinosinusitis, smoking status, and history of NSAID-induced hypersensitivity reactions were sent to participants by mail. Totally, 62 737 participants completed the questionnaires.
  
  
  
  The mean prevalence of NSAID-induced dyspnea was 1.9% and was highest in the three Polish centers [Katowice (4.9%), Krakow (4.8%), and Lodz (4.4%)] and lowest in Skopje, (0.9%), Amsterdam (1.1%), and Umea (1.2%). In multivariate analysis, the prevalence of respiratory reactions to NSAIDs was higher in participants with chronic rhinosinusitis symptoms (Odds Ratio 2.12; 95%CI 1.78-2.74), asthma symptoms in last 12 months (2.7; 2.18-3.35), hospitalization due to asthma (1.53; 1.22-1.99), and adults vs children (1.53; 1.24-1.89), but was not associated with allergic rhinitis.
  
  
  
  Our study documented significant variation between European countries in the prevalence of NSAID-induced respiratory hypersensitivity reactions, and association with chronic airway diseases, but also with environmental factors.
authors.affiliation: Department of Rheumatology, Medical University of Łódź, Łódź, Poland. joanna.makowska@umed.lodz.pl.
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authors.initials: JS
authors.lastname: Makowska
authors.affiliation: Department of Respiratory Epidemiology and Public Health, Imperial College, London, UK.
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authors.affiliation: Department of Respiratory Epidemiology and Public Health, Imperial College, London, UK.
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authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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authors.affiliation: Upper Airways Research Laboratory, Department of Otorhinolaryngology and Logopaedic-Audiologic Science, Ghent University, Ghent, Belgium.
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authors.affiliation: Institute for Occupational Health of R. Macedonia, University ''Sts Cyril and Methodius'' Skopje, Skopje, Macedonia.
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authors.affiliation: Department of Epidemiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland.
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authors.affiliation: Upper Airways Research Laboratory, Department of Otorhinolaryngology and Logopaedic-Audiologic Science, Ghent University, Ghent, Belgium.
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authors.affiliation: Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark.
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authors.affiliation: Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
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authors.affiliation: Department of Respiratory Medicine, Montpellier University, Montpellier, France.
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authors.affiliation: Department of Respiratory Medicine, Montpellier University, Montpellier, France.
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authors.lastname: Bousquet
authors.affiliation: Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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authors.affiliation: Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: S E
authors.initials: SE
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authors.affiliation: Unit of Heart and Lung Diseases, Karolinska Institutet, Stockholm, Sweden.
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authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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authors.lastname: Fokkens
authors.affiliation: Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
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authors.affiliation: Department of Respiratory Medicine, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
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authors.affiliation: Department of Respiratory Cell and Molecular Biology, University of Southampton, Southampton, UK.
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authors.lastname: Howarth
authors.affiliation: Department of Respiratory Cell and Molecular Biology, University of Southampton, Southampton, UK.
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authors.lastname: Salagean
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsla, Sweden.
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authors.affiliation: Department of Internal Medicine, Jagiellonian University Krakow, Krakow, Poland.
authors.forename: L
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authors.lastname: Kasper
authors.affiliation: Environmental Health Research Institute, Heinrich Heine University, Dusseldorf, Germany.|Department of Dermatology and Allergy, Technical University Munich, Munich, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Kraemer
authors.affiliation: Department of Immunology and Allergology, University Hospital Coimbra, Coimbra, Portugal.
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authors.lastname: Louiro
authors.affiliation: Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden.
authors.forename: B
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authors.lastname: Lundback
authors.affiliation: Institute for Occupational Health of R. Macedonia, University ''Sts Cyril and Methodius'' Skopje, Skopje, Macedonia.
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authors.lastname: Minov
authors.affiliation: Department of Internal Medicine, Jagiellonian University Krakow, Krakow, Poland.
authors.forename: E
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authors.lastname: Nizankowska-Mogilnicka
authors.affiliation: Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece.
authors.forename: N
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authors.lastname: Papadopoulos
authors.affiliation: Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece.
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authors.initials: AG
authors.lastname: Sakellariou
authors.affiliation: Department of Immunology and Allergology, University Hospital Coimbra, Coimbra, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Todo-Bom
authors.affiliation: Department of Otorhinolaryngology and Finnish Institute of Occupational Health, Helsinki University Hospital, Helsinki, Finland.|Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
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authors.lastname: Toskala
authors.affiliation: Department of Epidemiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland.
authors.forename: J E
authors.initials: JE
authors.lastname: Zejda
authors.affiliation: Department of Dermatology and Allergy, Charite'- Universitahtsmedizin Berlin, Berlin, Germany.
authors.forename: T
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authors.lastname: Zuberbier
authors.affiliation: Department of Immunology, Rheumatology and Allergy, Medical University of Łódź, Łódź, Poland.
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mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012130:Respiratory Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: GA2LEN; NSAIDs hypersensitivity; drug allergy; epidemiology