Tolerability to nabumetone and meloxicam in patients with nonsteroidal anti-inflammatory drug intolerance.
BACKGROUND
Because nonsteroidal anti-inflammatory drug (NSAID) intolerance depends on COX-1 inhibition, preferential or selective COX-2 inhibitors have been thought to be well tolerated by these patients.


OBJECTIVE
The aim of this study is to evaluate tolerability to nabumetone and meloxicam in patients with NSAID intolerance.


METHODS
Seventy patients intolerant to NSAIDs were selected. Thirty subjects were patients with asthma with respiratory (rhinitis-asthma) intolerance to NSAIDs (group A); 40 patients (group B) had cutaneous-mucous (urticaria-angioedema) NSAID intolerance. Diagnosis was based on clinical histories in all patients, and it was confirmed by positive single-blind placebo-controlled oral challenge test in 36 patients. After written informed consent, a single-blind placebo-controlled oral challenge test with nabumetone in all patients (2 g except for 11 patients who reached 1 g) and meloxicam (15 mg) in 51 patients was performed.


RESULTS
Of the total selected, 94.3% tolerated 1 g nabumetone. In those who reached the 2-g dose, the tolerability was 83.6%. With respect to meloxicam, 96.1% of patients, tolerated 15 mg. No significant difference in nabumetone and meloxicam tolerability was observed between groups A and B.


CONCLUSIONS
The results of this study confirm a high percentage of tolerability to the maximum therapeutic dosage of nabumetone and meloxicam in patients with NSAID intolerance, both in those with cutaneous/mucous manifestations and in those with respiratory disease.


CONCLUSIONS
Nabumetone and meloxicam are safe alternatives in NSAID-intolerant patients.
Prieto
Alicia
A
Allergy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain. aprieto.hgugm@salud.madrid.org
De Barrio
Manuel
M
Martín
Elena
E
Fernández-Bohórquez
María
M
de Castro
Francisco Javier
FJ
Ruiz
Francisco Javier
FJ
Herrero
Teresa
T
Tornero
Pilar
P
Rubio
María
M
D000328:Adult; D000368:Aged; D000799:Angioedema / Q000188:drug therapy / Q000201:enzymology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy / Q000201:enzymology; D002074:Butanones / Q000009:adverse effects / Q000627:therapeutic use*; D051545:Cyclooxygenase 1 / Q000378:metabolism; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D018432:Drug Resistance, Multiple / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D000077430:Nabumetone; D012220:Rhinitis / Q000188:drug therapy / Q000201:enzymology; D016037:Single-Blind Method; D013843:Thiazines / Q000009:adverse effects / Q000627:therapeutic use*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002074:Butanones; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D013843:Thiazines; D013844:Thiazoles; D051545:Cyclooxygenase 1; D000077430:Nabumetone; D000077239:Meloxicam