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Scientific article
English

Toleranz von Coxiben bei Intoleranz gegenuber nicht-steroidalen Antirheumatika (NSAR)

Other titleTolerance to coxibs in patients with intolerance to non-steroidal anti-inflammatory drugs (NSAIDs)
Published inDeutsche Medizinische Wochenschrift, vol. 130, no. 40, p. 2249-2252
Publication date2005
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.

Keywords
  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Anaphylaxis/chemically induced
  • Angioedema/chemically induced
  • Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/*adverse effects
  • Cyclooxygenase Inhibitors/administration & dosage/*adverse effects
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • *Drug Hypersensitivity
  • Female
  • Humans
  • Isoxazoles/administration & dosage/*adverse effects
  • Male
  • Middle Aged
  • Skin Tests
  • Sulfonamides/administration & dosage/*adverse effects
  • Urticaria/chemically induced
Affiliation Not a UNIGE publication
Citation (ISO format)
BOEHNCKE, Sandra, BOEHNCKE, Wolf-Henning. Toleranz von Coxiben bei Intoleranz gegenuber nicht-steroidalen Antirheumatika (NSAR). In: Deutsche Medizinische Wochenschrift, 2005, vol. 130, n° 40, p. 2249–2252. doi: 10.1055/s-2005-918556
Identifiers
ISSN of the journal0012-0472
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