title: Selective cyclooxygenase-2 inhibitor cross-reactivity in aspirin-exacerbated respiratory disease.
abstract: Aspirin-induced asthma (AIA) is a severe and difficult-to-treat allergic disease in which acute asthma attacks are induced by nonsteroidal anti-inflammatory drugs. Patients with AIA rarely experience asthma attacks when taking celecoxib, a specific inhibitor of cyclooxygenase (COX) 2. A 33-year-old woman had a severe asthma attack with hypoxia and lost consciousness after oral provocation testing with 15 mg of aspirin and also with 50 mg of celecoxib. After 2 months of treatment with 10 mg/day of oral prednisolone, 1600 μg/day of inhaled fluticasone propionate, montelukast as a leukotriene receptor antagonist (LTRA), and long-term beta-agonist, we again challenged her with a provocation test with up to 200 mg of celecoxib; this time there were neither allergic symptoms nor decrease in forced expiratory volume in 1 second. Patients with severe or poorly controlled asthma may experience asthma attacks even if using selective COX-2 inhibitors. However, treatment with steroids and an LTRAs may inhibit asthma attacks induced by celecoxib.
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara Hospital, Kanagawa, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Umemoto
authors.forename: Naomi
authors.initials: N
authors.lastname: Tsurikisawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nogi
authors.forename: Kanako
authors.initials: K
authors.lastname: Iwata
authors.forename: Chiyako
authors.initials: C
authors.lastname: Oshikata
authors.forename: Sayaka
authors.initials: S
authors.lastname: Tatsuno
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tanimoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sekiya
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuburai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mitomi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Akiyama
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D055963:Asthma, Aspirin-Induced / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D000068579:Celecoxib; D003429:Cross Reactions; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D003521:Cyclopropanes; D005260:Female; D000068298:Fluticasone; D006801:Humans; D000860:Hypoxia; D007114:Immunization; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects*; D011804:Quinolines / Q000627:therapeutic use; D012129:Respiratory Function Tests; D013440:Sulfides; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000085:Acetates; D000318:Adrenergic beta-Agonists; D000730:Androstadienes; D052246:Cyclooxygenase 2 Inhibitors; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011720:Pyrazoles; D011804:Quinolines; D013440:Sulfides; D013449:Sulfonamides; D011239:Prednisolone; D000068298:Fluticasone; D000068579:Celecoxib; C093875:montelukast; D001241:Aspirin