| Title | [Tolerance to coxibs in patients with intolerance to non-steroidal anti-inflammatory drugs (NSAIDs)] | | Author(s) | Boehncke S, Boehncke WH | | Institution | Zentrum der Inneren Medizin, Abteilung Endokrinologie. Boehncke@em.uni-frankfurt.de | | Source | Dtsch Med Wochenschr 2005 Oct 7; 130(40):2249-52. | | MeSH | Administration, Oral
Adolescent
Adult
Aged
Anaphylaxis
Angioneurotic Edema
Anti-Inflammatory Agents, Non-Steroidal
Cyclooxygenase Inhibitors
Dose-Response Relationship, Drug
Double-Blind Method
Drug Hypersensitivity
English Abstract
Female
Humans
Isoxazoles
Male
Middle Aged
Skin Tests
Sulfonamides
Urticaria
| | Abstract | BACKGROUND AND
OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) frequently cause pseudoallergic reactions. Recognition of two different prostaglandin synthase iso-enzymes led to the development of the so-called coxibs preferentially inhibiting cyclooxygenase-2. We studied tolerability of valdecoxib preferentially inhibitng cyclooxygenase-2 in patients with a history of intolerance to NSAIDs.
PATIENTS AND METHODS: 41 patients (30 female, 11male, age 14-74 years) with a history of intolerance to NSAIDs underwent scratch tests with these drugs and valdecoxib, followed by oral challenge with valdecoxib (maximum single dose: 20 mg; cumulative dose: 35mg) in a double-blind, placebo-controlled manner.
RESULTS: The history of intolerance to NSAID comprised urticaria as the leading symptom (n = 26), followed by angioedema (n = 11) and anaphylactoid shock (n = 4). 21 patients reported reactions to only one NSAID, 15 identified 2 different triggering drugs, and 5 patients showed reactions to 3 different NSAIDs. Acetylsalicylic acid (n = 20) and diclofenac (n = 12) were the most frequent causative drugs. Upon oral challenge with valdecoxib, one patient developed generalized urticaria within 30 minutes following the last dose of valdecoxib; symptoms resolved after i. v. injection of 2 mg clemastine and 250 mg prednisolone. All other patients tolerated the oral challenge without adverse effects.
CONCLUSION: Our results are in line with previous studies suggesting that preferential cyclooxygenase-2-inhibitors may safely be used by patients with known intolerance to NSAIDs. | | Language | ger | | Pub Type(s) | Clinical Trial
Controlled Clinical Trial
Journal Article
| | PubMed ID | 16208597 |
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