Celecoxib tolerability in patients with hypersensitivity (mainly cutaneous reactions) to nonsteroidal anti-inflammatory drugs.
BACKGROUND
Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly observed in clinical practice, particularly among patients with chronic urticaria or asthma. The identification of a safe and reliable alternative is a frequent problem for both general practitioners and allergists.


METHODS
We assessed 120 patients (83 women and 37 men) who had experienced adverse reactions to one or more NSAIDs; 64 (53.3%) of them had reacted to only one NSAID (single reactors) and 56 (46.7%) to multiple NSAIDs (multiple reactors). Among our subjects, 76.7% reported cutaneous reactions, 8.3% respiratory symptoms, 10.8% both cutaneous and respiratory symptoms, and 4.2% anaphylaxis. All patients were subjected to a single-blind, placebo-controlled oral challenge with two different doses of celecoxib (50 + 150 mg 1 h later = cumulative dose of 200 mg).


RESULTS
None of the patients reacted to the placebo and only one (0.8%) suffered a reaction (urticaria) after the second dose of celecoxib.


CONCLUSIONS
Celecoxib showed a 98.9% rate of tolerability in the 92 patients with exclusively cutaneous reactions and was well tolerated by all 28 subjects with NSAID-related respiratory or anaphylactic symptoms.
Viola
Marinella
M
Department of Internal Medicine and Geriatrics, UCSC-Allergy Unit, Complesso Integrato Columbus, Rome, Italy.
Quaratino
Donato
D
Gaeta
Francesco
F
Caringi
Mario
M
Valluzzi
Rocco
R
Caruso
Cristiano
C
Volpetti
Sabrina
S
Romano
Antonino
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000633:toxicity; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000633:toxicity*; D004342:Drug Hypersensitivity / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications; D008297:Male; D008875:Middle Aged; D011720:Pyrazoles / Q000633:toxicity*; D017445:Skin Diseases, Vascular / Q000139:chemically induced*; D013449:Sulfonamides / Q000633:toxicity*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib