{
  "abstract": "Background/aim\n\nData on the course of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity in NSAID-exacerbated cutaneous disease (NECD) are limited. We aimed to evaluate NSAID tolerance in NECD patients with well-controlled urticaria.Methods\n\n142 patients with well-controlled urticaria [Urticaria Control Test (UCT) ≥ 12; Urticaria Activity Score over 7 days (UAS7) ≤ 6] underwent a single blind, placebo-controlled acetylsalicylic acid (ASA) provocation test. Patients were categorized into three groups based on their treatment; omalizumab, antihistamine, or no treatment.Results\n\nThe median age of the patients was 40 years (IQR 31.5-52), and 79.6% were female. The median disease duration of chronic spontaneous urticaria (CSU) was 4 years (IQR 2-8). The ASA provocation test was positive in 29 patients (20.4%). Positive patients had lower UCT and higher UAS7 scores (both p < 0.001). ASA provocation test positivity was more common in the antihistamine group compared to both the omalizumab (p = 0.001) and untreated groups (p < 0.001). ROC analysis showed that UCT ≤ 15 predicted ASA provocation test positivity with 72.4% sensitivity and 83.2% specificity, while UAS7 ≥ 4 predicted positivity with 72.4% sensitivity and 86.7% specificity. The negative predictive values (NPV) were 92.2% and 92.5%, respectively.Conclusion\n\nTo our knowledge, this is the first study to demonstrate, in a large NECD cohort, that NSAID tolerance can be achieved in patients with well-controlled urticaria under different treatment modalities, regardless of complete remission status. UCT ≤ 15 and UAS7 ≥ 4 are useful clinical predictors of provocation test positivity and, given their high NPVs, are particularly valuable for excluding positivity.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Division of Allergy and Clinical Immunology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Merve Hormet Igde",
      "orcid": "0000-0003-1940-3419"
    },
    {
      "affs": [
        0
      ],
      "name": "Pelin Korkmaz",
      "orcid": "0000-0002-0225-2485"
    },
    {
      "affs": [
        0
      ],
      "name": "Semra Demir",
      "orcid": "0000-0003-3449-5868"
    },
    {
      "affs": [
        0
      ],
      "name": "Osman Ozan Yegit",
      "orcid": "0000-0003-4256-6048"
    },
    {
      "affs": [
        0
      ],
      "name": "Derya Ünal",
      "orcid": "0000-0001-9741-5939"
    },
    {
      "affs": [
        0
      ],
      "name": "Merve Dilşad Atasever",
      "orcid": "0000-0003-3996-5929"
    },
    {
      "affs": [
        0
      ],
      "name": "Ayşe Feyza Aslan"
    },
    {
      "affs": [
        0
      ],
      "name": "Leyla Bölek",
      "orcid": "0000-0001-9844-3624"
    },
    {
      "affs": [
        0
      ],
      "name": "Selin Ece Güzel",
      "orcid": "0000-0002-1421-5964"
    },
    {
      "affs": [
        0
      ],
      "name": "Nevzat Kahveci",
      "orcid": "0000-0001-7050-6101"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehmet Emin Sezgin",
      "orcid": "0000-0002-7654-283X"
    },
    {
      "affs": [
        0
      ],
      "name": "Şule Çelik Kamacı",
      "orcid": "0000-0001-7132-2400"
    },
    {
      "affs": [
        0
      ],
      "name": "Esra Kaya"
    },
    {
      "affs": [
        0
      ],
      "name": "Bircan Erden",
      "orcid": "0009-0003-2943-4697"
    },
    {
      "affs": [
        0
      ],
      "name": "Asli Gelincik",
      "orcid": "0000-0002-3524-9952"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2zgpe7g0snwph.bib",
  "cited_by": 0,
  "doi": "10.1002/clt2.70216",
  "fulltext_url": "https://europepmc.org/articles/PMC13687787",
  "id": "2zgpe7g0snwph",
  "issns": [
    "2045-7022"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908253",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2745|Urticaria and Related Conditions"
    ]
  ],
  "openalex": "W7223171385",
  "pdf_url": "https://europepmc.org/articles/PMC13687787?pdf=render",
  "pmcid": "PMC13687787",
  "pmid": "42908253",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2zgpe7g0snwph.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42908253",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908253"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2745|Urticaria and Related Conditions",
      "subfield": "general"
    }
  ],
  "title": "NSAID Tolerance Can Be Restored in NECD Even in the Absence of Complete Remission of Urticaria.",
  "title_text": "NSAID Tolerance Can Be Restored in NECD Even in the Absence of Complete Remission of Urticaria.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/2zgpe7g0snwph",
  "venue": "Clinical and translational allergy",
  "versions": []
}