title: Intolerance reactions due to the selective cyclooxygenase type II inhibitors rofecoxib and celecoxib. Results of oral provocation tests in patients with NSAID hypersensitivity.
abstract: Intolerance reactions due to the ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) are frequent emergencies. It is thought that inhibition of the isoenzyme cyclooxygenase type I (COX-1) is responsible for the common NSAID-associated adverse effects, whereas inhibition of COX-2 is mainly responsible for the therapeutic effects. The goal of our study was to estimate the frequency of intolerance reactions due to ingestion of the two newly approved selective COX-2 inhibitors, rofecoxib or celecoxib. In a sample of 13 patients who had previously documented NSAID hypersensitivity reactions to non-selective COX inhibitors, 2 patients (15.3%) showed intolerance reactions (2 of 9 patients with rofecoxib, 1 of 5 patients with celecoxib). These drugs cannot therefore be administered uncritically to patients with known NSAID hypersensitivity. Selective COX-2 inhibitors can only be used as alternative drugs in these patients after assessing their specific tolerability in a properly performed provocation test.
authors.affiliation: Department of Dermatology, University Hospital Duesseldorf, Duesseldorf, Germany. rkruse@uni-duesseldorf.de
authors.forename: Roland
authors.initials: R
authors.lastname: Kruse
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Markus
authors.initials: M
authors.lastname: Grewe
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007783:Lactones / Q000009:adverse effects*; D011720:Pyrazoles; D013449:Sulfonamides / Q000009:adverse effects*; D013450:Sulfones
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D011720:Pyrazoles; D013449:Sulfonamides; D013450:Sulfones; C116926:rofecoxib; D000068579:Celecoxib