title: Tolerability of rofecoxib in patients with cutaneous adverse reactions to nonsteroidal anti-inflammatory drugs.
abstract: BACKGROUND
  Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are very common problems in clinical practice. Rofecoxib is a novel NSAID which selectively inhibits prostaglandin endoperoxide H synthase-2 and has no effect on prostaglandin endoperoxide H synthase-1.
  
  
  OBJECTIVE
  To evaluate the tolerability of rofecoxib in NSAID-sensitive patients with cutaneous adverse reactions.
  
  
  METHODS
  One hundred thirty-nine patients with NSAID-induced adverse reactions [60 urticaria alone (43.1%), 34 angioedema (24.5%), 34 angioedema plus urticaria (24.5%), 5 urticaria plus difficulty in breathing (3.6%), 4 maculopapular rush (2.9%), and 2 Stevens-Johnson syndrome (1.4%)] were submitted to a single-blind, placebo-controlled peroral challenge with increasing doses of rofecoxib.
  
  
  RESULTS
  One hundred thirty-eight of 139 (99.3%) patients tolerated rofecoxib without adverse reactions; only one (0.7%) experienced weak urticaria localized at arms.
  
  
  CONCLUSIONS
  Rofecoxib is a well tolerated drug in patients with NSAID cutaneous adverse reactions and it may represent a valid alternative drug in NSAID-sensitive patients.
authors.affiliation: Department of Clinical Immunology and Allergology, University of Bari, Italy. e.nettis@allergy.uniba.it
authors.forename: Eustachio
authors.initials: E
authors.lastname: Nettis
authors.forename: Paola Roberto
authors.initials: PR
authors.lastname: Di
authors.forename: Antonio
authors.initials: A
authors.lastname: Ferrannini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Tursi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D051545:Cyclooxygenase 1; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D007783:Lactones / Q000009:adverse effects*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D011451:Prostaglandin-Endoperoxide Synthases; D012871:Skin Diseases / Q000139:chemically induced*; D012882:Skin Tests; D013450:Sulfones
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007527:Isoenzymes; D007783:Lactones; D008565:Membrane Proteins; D013450:Sulfones; C116926:rofecoxib; D051545:Cyclooxygenase 1; C496511:PTGS1 protein, human; D011451:Prostaglandin-Endoperoxide Synthases