Utility of Basophil Activation Test in the diagnosis of cross-intolerance Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) reactions in Vietnamese patients.

Abstract

Purpose: We focus on the utility of Basophil Activation Test in diagnosing cross-intolerance reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) among Vietnamese patients. Our objectives include selecting optimal allergens, determining appropriate concentrations, and defining cut-off values for BAT.

Methods: In this validation study, we employed the case-control method in a cohort of 30 patients previously diagnosed with NSAIDs-induced cross-intolerance and 32 healthy volunteers were included as controls. The confirmation of cross-intolerance NSAIDs hypersensitivity followed the guidelines set forth by the EAACI/GA2LEN group. This process involved assessing clinical history, with or without a drug provocation test. Both groups underwent the BAT with two different concentrations of two NSAIDs: Lysine-Aspirin at 1.25 mg/mL and 0.5 mg/mL, as well as Ketorolac at 1.2 mg/mL and 0.5 mg/mL.

Results: The suitable allergen for the BAT of cross-intolerance NSAIDs hypersensitivity is Aspirin, with the optimal concentration is 1,25mg/ml. The positive threshold of the test for Aspirin 1,25mg/ml is determined as the rate of Activated Basophils ≥ 4%, Stimulation Index (SI) ≥ 1,5; sensitivity 60%, specificity 93,8%.

Conclusions: BAT demonstrates its potential utility in diagnosing non-immunological reactions triggered by NSAIDs. With its high specificity, BAT has the potential to serve as a viable alternative to the drug provocation test, effectively preventing the occurrence of severe, and possibly even anaphylactic, reactions.