Hydrocortisone sodium succinate does not cross-react with aspirin in aspirin-sensitive patients with asthma.
BACKGROUND
Bronchospasm after intravenous hydrocortisone treatment has been reported in some patients with aspirin-sensitive respiratory disease.


OBJECTIVE
This study was designed to determine the prevalence of sensitivity to hydrocortisone among patients with aspirin-sensitive respiratory disease.


METHODS
We performed double-blind, placebo-controlled challenges with aspirin and 100 mg of hydrocortisone sodium succinate administered intravenously in 53 subjects.


RESULTS
Forty-five of the 53 subjects (85%) undergoing oral aspirin challenge experienced respiratory reactions to aspirin. Forty-four of these 45 patients had neither naso-ocular, cutaneous, nor respiratory reactions to hydrocortisone sodium succinate. One aspirin-sensitive subject had bronchospasm and a naso-ocular reaction to hydrocortisone sodium succinate and a naso-ocular reaction with minimal bronchospasm to methylprednisolone sodium succinate. After desensitization to aspirin, and while receiving maintenance aspirin therapy, this subject again reacted to hydrocortisone sodium succinate with bronchospasm and naso-ocular reaction.


CONCLUSIONS
We conclude that aspirin-sensitive patients with asthma are not preferentially sensitive to hydrocortisone and that hydrocortisone sodium succinate does not cross-react or cross-desensitize with aspirin.
Feigenbaum
B A
BA
Scripps Clinic and Research Foundation, La Jolla, CA 92037, USA.
Stevenson
D D
DD
Simon
R A
RA
D000328:Adult; D001241:Aspirin / Q000276:immunology* / Q000494:pharmacology; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology*; D003429:Cross Reactions; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D004342:Drug Hypersensitivity / Q000276:immunology* / Q000628:therapy; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000276:immunology* / Q000627:therapeutic use*; D010919:Placebos
D010919:Placebos; D001241:Aspirin; D006854:Hydrocortisone