[Tolerance to celecoxib and meloxicam in patients with intolerance to nonsteroidal anti-inflammatory drugs].
BACKGROUND
Hypersensitive reactions to analgesics in the general population are less than 1%. Previous studies have demonstrated that cyclooxigenase 2 (COX-2) inhibitors are an efficient alternative in patients with non-steroidal anti-inflammatory drugs (NSAIDs) intolerance. The aim of our study is to test the tolerance to celecoxib and meloxicam in patients with NSAIDs intolerance, upto dosages higher than those used in previous studies.


METHODS
The subjects of the study were 38 NSAID-sensitive patients from September 2004 to June 2005. The diagnosis of intolerance to NSAIDs was carried out by means of single-blind placebo-controlled oral challenge with aspirin. We performed single-blind placebo controlled oral challenge tests with celecoxib (accumulated dose of 400 mg) and meloxicam (accumulated dose of 15 mg).


RESULTS
There was only one reaction with celecoxib (97.3%) which was generalised urticaria after the dose of 400 mg accumulated, it should be pointed out that this patient tolerated perfectly the dose of 200 mg. For meloxicam, we found 100% tolerance at a dosage of 15 mg, including the patient who showed a reaction to the celecoxib.


CONCLUSIONS
We consider that there are patients with tolerance to low dosages of COX-2 inhibitors who show a reaction on increasing the administered dosage, which means that their tolerance should be taken into account and checked in the long term.
Vázquez-Cortés
S
S
Servicio de Alergia, Hospital Clínico San Carlos, Madrid, Spain. sonia.vazquez.cortes@gmail.com
Vázquez-Fuertes
L
L
Rodríguez-Alvarez
M
M
Reig Rincón de Arellano
I
I
Martínez-Cócera
C
C
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000068579:Celecoxib; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D016037:Single-Blind Method; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D013843:Thiazines / Q000008:administration & dosage / Q000627:therapeutic use*; D013844:Thiazoles / Q000008:administration & dosage / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D013843:Thiazines; D013844:Thiazoles; D000068579:Celecoxib; D000077239:Meloxicam