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Vertraglichkeit des selektiven Cyclooxygenase-2-Inhibitors Rofecoxib bei Intoleranz gegenuber nicht-steroidalen Antiphlogistika

Zollner, Thomas Matthias
Ahlbach, Sandra
Kaufmann, Roland
Published in Deutsche Medizinische Wochenschrift. 2001, vol. 126, no. 14, p. 386-388
Abstract BACKGROUND AND OBJECTIVE: Pseudoallergic reactions triggered by nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of the enzyme cyclooxygenase-1, whereas their therapeutic effects are mediated by inhibition of cyclooxygenase-2. This study analyzed the tolerability of the selective cyclooxygenase-2-inhibitor rofecoxib in patients who encountered pseudoallergic reactions to NSAIDs. PATIENTS AND METHODS: 37 patients (12 males, 25 females, mean age 35 years [15-75 years]) with a history of pseudoallergic reactions to NSAIDs underwent standardized skin prick, scratch and patch tests along with oral placebo-controlled blinded exposure to rofecoxib (maximum single dose 12.5 mg, cumulative dose 25 mg). RESULTS: 23 patients had skin reactions, 4 times respiratory symptoms were documented, and in 10 cases cutaneous as well as respiratory symptoms were reported. Salicylic acid was identified as the most common trigger for a pseudoallergic reaction (n = 28). In 9 cases several non-steroidal antiphlogistics of different chemical groups caused symptoms. All skin tests showed negative results. Oral challenge with rofecoxib was tolerated by all 37 patients without adverse effects. CONCLUSION: Given the high incidence of pseudoallergic reactions to NSAIDs the use of selective cyclooxygenase-2-inhibitors represents a therapeutic alternative as well as a means of prevention of the described reactions.
Keywords AdolescentAdultAged*Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/adverse effects*Cyclooxygenase Inhibitors/administration & dosage/adverse effectsDrug Eruptions/diagnosis/etiology/prevention & controlDrug Hypersensitivity/diagnosis/*etiology/prevention & controlFemaleHumans*Lactones/administration & dosage/adverse effectsMaleMiddle AgedPlacebosSkin TestsSulfones
PMID: 11332239
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ZOLLNER, Thomas Matthias et al. Vertraglichkeit des selektiven Cyclooxygenase-2-Inhibitors Rofecoxib bei Intoleranz gegenuber nicht-steroidalen Antiphlogistika. In: Deutsche Medizinische Wochenschrift, 2001, vol. 126, n° 14, p. 386-388.

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Deposited on : 2013-09-20

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