{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:33:24Z","timestamp":1790969604886,"version":"4.1.0"},"reference-count":92,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2007,7,1]],"date-time":"2007-07-01T00:00:00Z","timestamp":1183248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate and provide management strategies for patients with aspirin or nonselective nonsteroidal antiinflammatory drug (NSAID) sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>Literature retrieval was accessed through MEDLINE (1966\u2013March 2007) using the terms acetaminophen, aspirin, antiinflammatory agents nonsteroidal, urticaria, angioedema, asthma, leukotriene antagonists, desensitization, and tacrolimus. Article references retrieved were hand-searched for other relevant articles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>All studies published in English were evaluated. Studies, review articles, and commentaries on aspirin-induced asthma and aspirin- or NSAID-induced urticaria\/angioedema were included in the review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Aspirin sensitivity is most often manifested as respiratory reactions (eg, bronchospasm, profuse rhinorrhea, conjunctival injection) or urticaria\/angioedema. The primary mechanism is believed to be inhibition of the cyclooxygenase 1 (COX-1) enzyme; as such, patients with aspirin sensitivity often display cross-reactions to nonselective NSAIDs that inhibit the COX-1 enzyme. Management strategies include avoidance of aspirin and cross-reacting nonselective NSAIDs. However, desensitization to aspirin is a viable option for patients with aspirin-induced respiratory reactions, especially for those who require aspirin for thromboembolic prophylaxis. Aspirin desensitization is maintained indefinitely with a daily aspirin dose. There is limited evidence of the use of leukotriene modifiers in preventing aspirin-induced asthma. COX-2 selective NSAIDs, especially in patients with aspirin-induced asthma, have not been found to cross-react. However, approximately 4% of patients with a history of aspirin-induced skin reactions may experience a cutaneous reaction following a challenge to a COX-2 selective NSAID. Since acetaminophen is a weak inhibitor of the COX-1 enzyme, patients with aspirin-induced asthma should not take more than 1000 mg of acetaminophen in a single dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Management of patients with aspirin\/NSAID sensitivity includes avoidance of aspirin\/nonselective NSAIDs, use of COX-2 selective NSAIDs, acetaminophen in doses less than 1000 mg, and desensitization. The role of leukotriene modifiers requires further study before they can be recommended for patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1k023","type":"journal-article","created":{"date-parts":[[2007,7,3]],"date-time":"2007-07-03T20:29:37Z","timestamp":1183494577000},"page":"1191-1200","source":"Crossref","is-referenced-by-count":18,"title":["Management Options for Patients with Aspirin and Nonsteroidal Antiinflammatory Drug Sensitivity"],"prefix":"10.1177","volume":"41","author":[{"given":"Sandra R","family":"Knowles","sequence":"first","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Department of Pharmacy and Drug Safety Clinic, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Drucker","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Drug Safety Clinic, Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Weber","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Drug Safety Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil H","family":"Shear","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Department of Medicine, Division of Dermatology, Drug Safety Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2007,7,1]]},"reference":[{"key":"bibr1-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2004.03.001"},{"key":"bibr2-aph.1K023","first-page":"329","volume":"14","author":"Sanchez-Borges M","year":"2004","journal-title":"J Investig Allergol Clin Immunol"},{"key":"bibr3-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1980.tb01730.x"},{"key":"bibr4-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7437.434"},{"key":"bibr5-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62221-1"},{"key":"bibr6-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.24.3017"},{"key":"bibr7-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1487"},{"key":"bibr8-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2004.00801.x"},{"key":"bibr9-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.7.569"},{"key":"bibr10-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2003.00267.x"},{"key":"bibr11-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/28.4.717"},{"key":"bibr12-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.08.035"},{"key":"bibr13-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2005.00740.x"},{"key":"bibr14-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.016003432.x"},{"key":"bibr15-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.suppl_2.S66"},{"key":"bibr16-aph.1K023","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200464210-00004"},{"key":"bibr17-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2003.00186.x"},{"key":"bibr18-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.019687"},{"key":"bibr19-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2230.2003.01228.x"},{"key":"bibr20-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-005-0067-z"},{"key":"bibr21-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2005.12.053"},{"key":"bibr22-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1444"},{"key":"bibr23-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2003.12.323"},{"key":"bibr24-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1097\/01.all.0000235899.57182.d4"},{"key":"bibr25-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1988.tb02838.x"},{"key":"bibr26-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2001.01189.x"},{"key":"bibr27-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.suppl_2.S70"},{"key":"bibr28-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2002.13447.x"},{"key":"bibr29-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.0014-2972.2001.00954.x"},{"key":"bibr30-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.139.12.1577"},{"key":"bibr31-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2001.00025.x"},{"key":"bibr32-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.12.023"},{"key":"bibr33-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.suppl_2.S42"},{"key":"bibr34-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(79)90036-8"},{"key":"bibr35-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013508"},{"key":"bibr36-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(82)90081-1"},{"key":"bibr37-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61803-0"},{"key":"bibr38-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(96)70123-9"},{"key":"bibr39-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.7"},{"key":"bibr40-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2006.09.011"},{"key":"bibr41-aph.1K023","first-page":"1287","volume":"127","author":"Mardiney M","year":"2001","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"bibr42-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.3.316"},{"key":"bibr43-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60692-8"},{"key":"bibr44-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1470"},{"key":"bibr45-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1081\/JAS-120037650"},{"key":"bibr46-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.10.022"},{"key":"bibr47-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2000.104571"},{"key":"bibr48-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H437"},{"key":"bibr49-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6419.745"},{"key":"bibr50-aph.1K023","first-page":"305","volume":"16","author":"Grzelewska-Rzymowska I","year":"1988","journal-title":"Allerg Immunol (Paris)"},{"key":"bibr51-aph.1K023","first-page":"1747","volume-title":"Allergy: principles and practice","volume":"2","author":"Stevenson DD","year":"1993"},{"key":"bibr52-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1A151"},{"key":"bibr53-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62575-6"},{"key":"bibr54-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00100303"},{"key":"bibr55-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1398-9995.2003.00351.x"},{"key":"bibr56-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2745.2002.01501.x"},{"key":"bibr57-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61150-7"},{"key":"bibr58-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.165.1.2010080"},{"key":"bibr59-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00797.x"},{"key":"bibr60-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.120275"},{"key":"bibr61-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62457-X"},{"key":"bibr62-aph.1K023","first-page":"156","volume":"15","author":"Serrano C","year":"2005","journal-title":"J Investig Allergol Clin Immunol"},{"key":"bibr63-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62297-1"},{"key":"bibr64-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.09.003"},{"key":"bibr65-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.05.020"},{"key":"bibr66-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.57.s72.14.x"},{"key":"bibr67-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1081\/JAS-120026063"},{"key":"bibr68-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1C497"},{"key":"bibr69-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2006.12.616"},{"key":"bibr70-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2001.01075.x"},{"key":"bibr71-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.6.1812"},{"key":"bibr72-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1002\/art.10426"},{"key":"bibr73-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.116290"},{"key":"bibr74-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1159\/000073268"},{"key":"bibr75-aph.1K023","first-page":"215","volume":"36","author":"Senna G","year":"2004","journal-title":"Ann Allergy Clin Immunol"},{"key":"bibr76-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1081\/JAS-51326"},{"key":"bibr77-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61392-0"},{"key":"bibr78-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1450"},{"key":"bibr79-aph.1K023","first-page":"10","volume":"38","author":"Micheletto C","year":"2006","journal-title":"Allerg Immunol (Paris)"},{"key":"bibr80-aph.1K023","first-page":"20","volume":"13","author":"Martin-Garcia C","year":"2003","journal-title":"J Investig Allergol Clin Immunol"},{"key":"bibr81-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.10.021"},{"key":"bibr82-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.6.2155"},{"key":"bibr83-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1097\/01.mjt.0000125121.35422.b4"},{"key":"bibr84-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61169-6"},{"key":"bibr85-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61205-7"},{"key":"bibr86-aph.1K023","first-page":"249","volume":"15","author":"Liccardi G","year":"2005","journal-title":"J Investig Allergol Clin Immunol"},{"key":"bibr87-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61282-3"},{"key":"bibr88-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)61281-1"},{"key":"bibr89-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.105.085431"},{"key":"bibr90-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(95)70290-3"},{"key":"bibr91-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(05)80179-4"},{"key":"bibr92-aph.1K023","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.93.03050535"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1K023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1K023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:09:25Z","timestamp":1777374565000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1K023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,7]]},"references-count":92,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2007,7]]}},"alternative-id":["10.1345\/aph.1K023"],"URL":"https:\/\/doi.org\/10.1345\/aph.1k023","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,7]]}}}