title: Tolerability of selective cyclooxygenase inhibitor, celecoxib, in patients with analgesic intolerance.
abstract: Intolerance reactions to acetyl salicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of COX-1 enzyme. Therefore, drugs that selectively inhibit COX-2 enzyme may be safe in these subjects. In this study, we evaluated the tolerability of celecoxib, a selective COX-2 inhibitor, in patients with analgesic intolerance. The eligible study population consisted of patients with a history of urticaria/angioedema, naso-ocular symptoms, bronchospasm, and/or anaphylactoid reaction induced by ASA and/or NSAIDs. A single-blind, placebo-controlled oral challenge test was performed in the hospital setting. On 2 separate days, 1/4 and 3/4 divided doses of placebo and celecoxib (Celebrex 200 mg, Pfizer, Turkey) were given with 2-hour intervals. Seventy-five subjects (mean age: 38.2 +/- 1.4 years; F:M: 55:20) were included in the study. Twenty-one subjects had asthma. No reaction was observed with placebo or celecoxib provocation. Although celecoxib seems to be a safe alternative drug in our study group, considering its serious adverse events reported in the literature, the drug should be recommended for patients with analgesic intolerance only after being tested by an experienced allergist.
authors.affiliation: Department of Chest Diseases, Division of Allergy, Ankara University School of Medicine, Cebeci Hospital, Ankara, Turkey. gcelik@medicine.ankara.edu.tr
authors.forename: Gülfem
authors.initials: G
authors.lastname: Celik
authors.forename: Gülden
authors.initials: G
authors.lastname: Paşaoğlu
authors.forename: Sevim
authors.initials: S
authors.lastname: Bavbek
authors.forename: Oznur
authors.initials: O
authors.lastname: Abadoğlu
authors.forename: Berna
authors.initials: B
authors.lastname: Dursun
authors.forename: Dilşad
authors.initials: D
authors.lastname: Mungan
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Misirligil
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001986:Bronchial Spasm / Q000139:chemically induced; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004342:Drug Hypersensitivity; D005260:Female; D006801:Humans; D008297:Male; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000187:drug effects*; D011720:Pyrazoles / Q000627:therapeutic use*; D012220:Rhinitis / Q000139:chemically induced; D016037:Single-Blind Method; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014581:Urticaria / Q000139:chemically induced
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib; D001241:Aspirin