[Tolerance to coxibs in patients with intolerance to non-steroidal anti-inflammatory drugs (NSAIDs)]

S Boehncke, W-H Boehncke
Deutsche Medizinische Wochenschrift 2005 October 7, 130 (40): 2249-52

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.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"