Celecoxib, a highly selective COX-2 inhibitor, is safe in aspirin-induced asthma patients.
BACKGROUND
In 5-10% of adult patients with asthma, aspirin and most other nonsteroidal anti-inflammatory drugs (NSAIDs) precipitate acute asthmatic attacks. Therefore, choosing an alternative anti-inflammatory agent for patients who have suffered adverse reactions to a nonsteroidal anti-inflammatory agent is a common problem in clinical practice. The discoveries that cyclooxygenase COX-2 is an inducible form of COX involved in inflammation and COX-1 is the major isoform responsible for the production of prostaglandins have provided a reasonable basis for the development of specific COX-2 inhibitors as a new class of anti-inflammatory agents.


OBJECTIVE
The purpose of this study is to demonstrate that celecoxib, a specific inhibitor of COX-2, does not cause asthmatic attacks in patients with aspirin and/or other nonsteroidal anti-inflammatory drug-induced asthma.


METHODS
We studied 33 patients, all of whom suffered from asthma induced by at least two different NSAID drugs. They were challenged in a single-blind manner with different doses of celecoxib on three different days, until either the therapeutic dose of 200 mg or intolerance was reached. Each patient was rechallenged with 200 mg celecoxib seven days later if no evidence of intolerance was previously observed.


RESULTS
Celecoxib 200 mg was proven to be well tolerated in all 30 three aspirin- and NSAID-induced asthma patients.


CONCLUSIONS
Our study appears to demonstrate that celecoxib is a suitable NSAID in aspirin-induced and/or nonsteroidal anti-inflammatory drug-induced asthma patients.
Martín-García
C
C
Department of Allergy, Hospital Ramón y Cajal, Madrid, Spain.
Hinojosa
M
M
Berges
P
P
Camacho
E
E
García-Rodriguez
R
R
Alfaya
T
T
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced*; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008297:Male; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases; D011720:Pyrazoles; D016037:Single-Blind Method; D013449:Sulfonamides / Q000009:adverse effects*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib; D001241:Aspirin