[The selective cyclooxygenase-2 inhibitor celecoxib is a safe alternative in patients with pseudo-allergic reactions to nonsteroidal anti-inflammatory drugs].
BACKGROUND
Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequent, and the need to identify a safe alternative drug is a common problem in clinical practice. We assessed the tolerability of the selective cyclooxygenase-2 inhibitor celecoxib in a group of NSAID-sensitive patients.


METHODS
77 patients (24 males, 53 females, age 31-80 years) with a history of adverse reactions to NSAIDs underwent standardized skin prick, scratch and patch tests along with oral, placebo-controlled blinded exposure to celecoxib (maximum single dose 200 mg, cumulative daily dose 350 mg).


RESULTS
21 patients had a history of cutaneous reactions only (urticaria), 25 had encountered respiratory symptoms (asthma), 18 reported cutaneous as well as respiratory symptoms, and in 13 patients an anaphylactoid shock occurred. Acetylsalicylic acid triggered symptoms in 38 patients. In 46 cases, several NSAIDs of different chemical groups caused symptoms. Oral challenge with celecoxib was tolerated by all 77 patients without adverse effects.


CONCLUSIONS
This study demonstrates that celecoxib does not have cross-intolerance to NSAIDs. Celecoxib is a safe alternative in subjects with previous adverse reactions to NSAIDs.
Ahlbach
Sandra
S
Zentrum der Inneren Medizin I, Johann Wolfgang Goethe-Universität, Frankfurt am Main.
Usadel
Klaus-Henning
KH
Kaufmann
Roland
R
Boehncke
Wolf-Henning
WH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D011720:Pyrazoles; D016037:Single-Blind Method; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib