title: Efficacy and tolerability of nimesulide in asthmatic patients intolerant to aspirin.
abstract: Inflammation of the airways accompanied by eosinophil infiltration appears to play a fundamental role in the pathogenesis of bronchial asthma. Therefore, anti-inflammatory agents (at present corticosteroids, cromoglycate and nedocromil) are the first-line treatment for this condition. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (acetylsalicylic acid) and indomethacin, however, have never been used in this setting, mainly for fear of adverse effects (e.g. severe obstructive reactions); these can occur, in a consistent number of patients as a consequence (according to the most widely accepted theory) of inhibition of prostaglandin synthesis. In a double-blind crossover placebo-controlled study involving 20 aspirin-sensitive patients with asthma, we found that oral nimesulide 100mg was well tolerated both clinically and functionally (no significant changes in forced expiratory volume in 1 second and specific airway resistance after drug intake). In a more recent study, we observed a mild obstructive reaction (easily controlled with inhaled bronchodilators) after oral administration of nimesulide 400mg to 3 patients who had previously tolerated a 100mg dose. On the basis of clinical experience, nimesulide (unlike most other NSAIDs) in the recommended doses appears to be well tolerated in aspirin-sensitive asthmatic patients. Furthermore, this distinctive anti-inflammatory agent might provide a novel approach to the treatment of bronchial asthma.
authors.affiliation: Institute of Cardiovascular and Respiratory Diseases, University of Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bianco
authors.forename: M
authors.initials: M
authors.lastname: Robuschi
authors.forename: G
authors.initials: G
authors.lastname: Petrigni
authors.forename: M
authors.initials: M
authors.lastname: Scuri
authors.forename: M G
authors.initials: MG
authors.lastname: Pieroni
authors.forename: R M
authors.initials: RM
authors.lastname: Refini
authors.forename: A
authors.initials: A
authors.lastname: Vaghi
authors.forename: P S
authors.initials: PS
authors.lastname: Sestini
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin; D001249:Asthma / Q000188:drug therapy* / Q000209:etiology; D002986:Clinical Trials as Topic; D000075202:Contraindications; D004347:Drug Interactions; D006801:Humans; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013449:Sulfonamides; D001241:Aspirin; C012655:nimesulide