Article

Etoricoxib tolerability in patients with hypersensitivity to nonsteroidal anti-inflammatory drugs.

Department of Internal Medicine and Geriatrics, UCSC-Allergy Unit, Complesso Integrato Columbus, Rome, Italy.
International Archives of Allergy and Immunology (impact factor: 2.4). 02/2007; 143(2):103-8. DOI:10.1159/000098658 pp.103-8
Source: PubMed

ABSTRACT Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly observed, particularly among patients with chronic urticaria or asthma. The identification of a safe and reliable alternative is a frequent problem in clinical practice. Our aim was to investigate the clinical tolerability of etoricoxib, a new selective cyclooxygenase-2 inhibitor, in a group of patients with well-established NSAID hypersensitivity.
We assessed 31 adults (21 women and 10 men) who reported one or more adverse reactions to NSAIDs, manifested as cutaneous, respiratory or anaphylactic symptoms. Sixteen of them reported reactions to a single NSAID (single reactors) and 15 to more than one NSAID (multiple reactors); the most frequently involved drug was acetylsalicylic acid. First, each patient underwent allergologic tests (skin and/or oral challenge tests) with culprit NSAIDs and then tolerability tests with increasing doses of etoricoxib up to 120 mg. All challenges were performed under single-blind, placebo-controlled conditions.
NSAID hypersensitivity was diagnosed in all 31 patients: 3 displayed positive results to pyrazolone skin tests and the other 28 to challenges with culprit NSAIDs. None reacted to either placebos or etoricoxib.
Etoricoxib seems to be a safe alternative for patients with well-demonstrated NSAID hypersensitivity.

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Keywords

31 adults
 
31 patients
 
allergologic tests
 
challenges
 
chronic urticaria
 
clinical tolerability
 
frequent problem
 
new selective cyclooxygenase-2 inhibitor
 
nonsteroidal anti-inflammatory drugs
 
NSAID hypersensitivity
 
one NSAID
 
oral challenge tests
 
placebo-controlled conditions
 
positive results
 
pyrazolone skin tests
 
safe alternative
 
single NSAID
 
tolerability tests
 
well-demonstrated NSAID hypersensitivity
 
well-established NSAID hypersensitivity
 

Marinella Viola