Safety of parecoxib in patients with nonsteroidal anti-inflammatory drug-induced urticaria or angioedema.
BACKGROUND
Parecoxib is the first injectable cyclooxygenase 2 selective inhibitor indicated for the treatment of acute postoperative pain.


OBJECTIVE
To describe the results of a challenge with parecoxib in patients with a history of urticaria or angioedema to 1 or more nonsteroidal anti-inflammatory drugs (NSAIDs).


METHODS
The study was performed from October 1, 2006, through March 31, 2007, with 79 patients who historically had experienced urticaria or angioedema after use of NSAIDs. The patients underwent a single-blind challenge with parecoxib, 40 mg.


RESULTS
No reaction to placebo was observed in any patient. Similarly, no reaction to parecoxib was observed in any patients in the single-class or multiple-class intolerance group.


CONCLUSIONS
Our report demonstrates that parecoxib does not induce cross-reactivity in patients with a history of urticaria or angioedema. Hence, this finding suggests that this drug could be safely proposed as an alternative (but only after a prior challenge) in patients with previous hypersensitive reactions to NSAIDs, even if there are added risk factors such as atopy and antimicrobial allergy, who require an analgesic drug perioperatively.
Colanardi
Maria Cristina
MC
Department of Medical Clinic, Immunology and Infectious Diseases, Division of Allergy and Clinical Immunology, University of Bari, Bari, Italy.
Nettis
Eustachio
E
Traetta
Pierluigi
P
Daprile
Carmela
C
Fitto
Carmela
C
Aloia
Anna Maria
AM
Di Leo
Elisabetta
E
Ferrannini
Antonio
A
Vacca
Angelo
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000799:Angioedema / Q000139:chemically induced / Q000276:immunology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D003429:Cross Reactions / Q000276:immunology; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000276:immunology*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D016896:Treatment Outcome; D014581:Urticaria / Q000139:chemically induced / Q000276:immunology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; C409945:parecoxib