Safety of selective cyclooxygenase-2 inhibitor rofecoxib in patients with NSAID-induced cutaneous reactions

Quiralte, J.; Pedro, B. Sáenz de San; Florido, J. José Fernando

doi:10.1016/s1081-1206(10)61912-6

Cited by 40 publications

(24 citation statements)

References 20 publications

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“…Interestingly, a history of intolerance to antibacterial drugs was not associated with any increased sensitivity to paracetamol or nimesulide. These results regarding the low sensitivity of NSAID-intolerant patients to nimesulide have been observed by others [395][396][397] and are indicative of some risks of developing urticaria and other related skin reactions from nimesulide being related largely to a history of sensitivity to other NSAIDs or anaphylaxis. Pastorello and co-workers [397] also observed an increase in intolerance to NSAIDs in patients that had a history of reactions to antimicrobial agents, although this was not so prevalent in patients that received nimesulide.…”

Section: Cutaneous Reactionssupporting

confidence: 83%

“…Using isolated bovine chondrocytes these authors observed that there was inhibition by nimesulide over a wide concentration range of NO production induced by the cytokines alone or as a mixture. Since NO is thought to be a stimulus to inflammatory events leading to metalloprotease or other enzymeinduced PrGn destruction [396][397][398] it appears that the inhibitory effects of nimesulide on NO production may, in part, account for the reduction in PrGn degradation observed in these studies.…”

Section: Production Of Pge 2 Cytokines and Proteoglycans In Vitromentioning

confidence: 99%

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Nimesulide — Actions and Uses

Rainsford¹

2005

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Section: Cutaneous Reactionssupporting

confidence: 83%

Section: Production Of Pge 2 Cytokines and Proteoglycans In Vitromentioning

confidence: 99%

Nimesulide — Actions and Uses

Rainsford¹

2005

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“…There are only two previous challenge‐proven studies with quite low numbers of patients. Meloxicam was challenged in only two patients and with a negative result among 15 patients with challenge‐proven NSAID‐induced UR/AE 24 . In another challenge‐proven study with 20 patients from Japan, six patients challenged with 10 mg of meloxicam and two responded (33.3%) with UR/AE 22 …”

Section: Discussionmentioning

confidence: 99%

Safety of meloxicam in patients with aspirin/non‐steroidal anti‐inflammatory drug‐induced urticaria and angioedema

Göksel

Aydın

Mısırlıgil

et al. 2010

The Journal of Dermatology

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It has been proposed that aspirin (ASA) and other non-steroidal anti-inflammatory drug (NSAID)-induced urticaria (UR)/angioedema (AE) are mediated through inhibition of cyclooxygenase-1 (COX-1) enzymes. Therefore, drugs with COX-2 selectivity may be well tolerated in such patients. We investigated the safety of preferential COX-2 inhibitor meloxicam in subjects with UR or AE type intolerance reaction to classical ASA/NSAIDs. Subjects with reliable or documented history of UR/AE due to classical ASA/NSAIDs underwent a single-blinded, placebo-controlled oral challenge with a cumulative dose of 7.5 mg meloxicam on 2 separate days. One-quarter and three-quarter divided doses of placebo and the active drug were given at 1-h intervals. A total of 116 patients (86 women and 30 men, mean age 39.6 ± 12.7 years) were enrolled to the study. The rate of atopy was 25.9%. Mean duration of drug reaction was 87.4 ± 110.8 (1-720) months. Almost half of the patients were multi-reactors. The most comorbid disease was asthma and the two most frequent NSAIDs inducing UR/AE were paracetamol (19. 6%) and ASA (19%). No reaction to placebo was observed. Ten out of 116 patients (8.6%) developed mild UR/AE, or only erythema and pruritus at a one-quarter or cumulative dose of 7.5 mg of meloxicam. The remaining subjects (91.4%) tolerated perfectly meloxicam challenge. This study indicates that 7.5 mg meloxicam is a safe alternative for ASA/NSAID-intolerant UR/AE patients. Intolerance reactions to meloxicam are much milder forms of the patients' historical ASA/NSAID-induced cutaneous reactions.

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“…In this context, theoretically, drugs that do not inhibit the COX-1 enzyme but inhibit COX-2 enzyme selectively may be safe in subjects with AI. Supporting this data in clinical practice, there are increasing reports about the safer use of new selective COX-2 inhibitor rofecoxib in patients with AI (10)(11)(12)(13)(14). A recently introduced NSAID, celecoxib, a 4-(5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl) benzene sulfonamide, has a selective inhibitory effect on COX-2 isoenzyme without any effect on COX-1 isoenzyme (15,16).…”

Section: Introductionmentioning

confidence: 90%

Tolerability of Selective Cyclooxygenase Inhibitor, Celecoxib, in Patients with Analgesic Intolerance

Çelik¹,

Pasaoğlu²,

Bavbek³

et al. 2004

LJAS

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Intolerance reactions to acetyl salicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of COX-1 enzyme. Therefore, drugs that selectively inhibit COX-2 enzyme may be safe in these subjects. In this study, we evaluated the tolerability of celecoxib, a selective COX-2 inhibitor, in patients with analgesic intolerance. The eligible study population consisted of patients with a history of urticaria/angioedema, naso-ocular symptoms, bronchospasm, and/or anaphylactoid reaction induced by ASA and/or NSAIDs. A single-blind, placebo-controlled oral challenge test was performed in the hospital setting. On 2 separate days, 1/4 and 3/4 divided doses of placebo and celecoxib (Celebrex 200 mg, Pfizer, Turkey) were given with 2-hour intervals. Seventy-five subjects (mean age: 38.2 +/- 1.4 years; F:M: 55:20) were included in the study. Twenty-one subjects had asthma. No reaction was observed with placebo or celecoxib provocation. Although celecoxib seems to be a safe alternative drug in our study group, considering its serious adverse events reported in the literature, the drug should be recommended for patients with analgesic intolerance only after being tested by an experienced allergist.

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Safety of selective cyclooxygenase-2 inhibitor rofecoxib in patients with NSAID-induced cutaneous reactions

Cited by 40 publications

References 20 publications

Nimesulide — Actions and Uses

Nimesulide — Actions and Uses

Safety of meloxicam in patients with aspirin/non‐steroidal anti‐inflammatory drug‐induced urticaria and angioedema

Tolerability of Selective Cyclooxygenase Inhibitor, Celecoxib, in Patients with Analgesic Intolerance

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