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The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross\u2010hypersensitivity reactions (CRs), associated with COX\u20101 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs\u2010exacerbated respiratory disease, NSAIDs\u2010exacerbated cutaneous disease and NSAIDs\u2010induced urticaria\/angioedema. Two phenotypes fill into the second one: single\u2010NSAID\u2010induced urticaria\/angioedema\/anaphylaxis and single\u2010NSAID\u2010induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re\u2010evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food\u2010dependent NSAID\u2010induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.<\/jats:p>","DOI":"10.1111\/all.14032","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T05:20:00Z","timestamp":1567142400000},"page":"561-575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":133,"title":["Progress in understanding hypersensitivity reactions to nonsteroidal anti\u2010inflammatory drugs"],"prefix":"10.1111","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-4878","authenticated-orcid":false,"given":"Inmaculada","family":"Do\u00f1a","sequence":"first","affiliation":[{"name":"Allergy Research Group Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA ARADyAL Malaga Spain"},{"name":"Allergy Unit Hospital Regional Universitario de M\u00e1laga 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