1. To confirm or exclude hypersensitivity in an unclear history.2. Gold standard for NSAID hypersensitivity.3. Verification of negative inhalation/nasal tests.4. Assessment before oral desensitization.
Gold standard mimicking natural exposure.Highest sensitivity (80–90%).
Systemic reaction risk.Long duration (1–3 days).Contraindicated if FEV1 < 70%, pregnancy, severe anaphylaxis, or beta-blocker use.
Bronchial aspirin provocation test
1. Diagnosis of NSAID hypersensitivity.2. Especially bronchial symptoms.
Safer and faster than oral challenge.Comparable sensitivity (77–90%).Rare systemic reactions.
Lower NPV.A negative test requires confirmation with an oral aspirin challenge.Contraindicated if FEV1 < 70%.
Intranasal aspirin provocation test
1. Upper airway symptoms.2. Alternative if oral/inhaled tests are contraindicated.3. Can be used as an initial safety test in sensitive patients.
Safer and quicker.Preferred when oral/inhaled tests are contraindicated.Usually mild local reactions.
Lower sensitivity (80–86.7%).A negative test requires confirmation with an oral aspirin challenge.Contraindicated in massive nasal polyposis or septal perforation.
Intravenous aspirin provocation test
Specialized centers to confirm NSAID hypersensitivity.
Reported safe and efficacious in selected centers.High sensitivity (~93.5%).
Rarely used outside Japan.Risk of severe adverse reactions.
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