title: Tolerability to etoricoxib in patients with aspirin-exacerbated respiratory disease.
abstract: BACKGROUND
  The use of selective cyclooxygenase (COX) 2 inhibitors as an alternative to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested for patients with aspirin-exacerbated respiratory disease (AERD).
  
  
  OBJECTIVE
  To evaluate tolerability to etoricoxib, a second-generation COX-2 inhibitor with high in vitro selectivity for COX-2 in patients with AERD.
  
  
  METHODS
  We conducted a retrospective review of patients with suspected aspirin intolerance seen between October 2007 and April 2012. Single-blind, placebo-controlled oral challenges with increasing doses of aspirin and etoricoxib were performed on 3 different days.
  
  
  RESULTS
  Of 262 patients with suspected aspirin intolerance, 248 underwent challenge testing with aspirin and 122 (49.2%) showed positive test results. In 104 of these aspirin-sensitive patients, etoricoxib was tested as an alternative drug and was tolerated in all but 3 (2.9%), who developed a positive asthmatic reaction.
  
  
  CONCLUSIONS
  The highly selective COX-2 inhibitor etoricoxib was tolerated in most but not all patients tested. An oral provocation test is therefore recommended before prescribing etoricoxib for patients with AERD.
authors: Department of Pulmonary Diseases, Fachkrankenhaus Coswig, Centre for Pulmonary Diseases and Thoracic Surgery, Coswig, Germany. dr.koschel@fachkrankenhaus-coswig.de
authors: D
authors: D
authors: Koschel
authors: C Ninck
authors: CN
authors: Weber
authors: G
authors: G
authors: Höffken
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use*; D055963:Asthma, Aspirin-Induced / Q000188:drug therapy* / Q000276:immunology; D051546:Cyclooxygenase 2 / Q000378:metabolism; D052246:Cyclooxygenase 2 Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D004361:Drug Tolerance / Q000276:immunology*; D000077613:Etoricoxib; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016037:Single-Blind Method; D013450:Sulfones / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D010919:Placebos; D011725:Pyridines; D013450:Sulfones; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D000077613:Etoricoxib