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Tolerance to COX ‐2 inhibitors in children with hypersensitivity to nonsteroidal anti‐inflammatory drugs
Author(s) -
Corzo J.L.,
Zambonino M.A.,
Muñoz C.,
Mayorga C.,
Requena G.,
Urda A.,
Gallego C.,
Blanca M.,
Torres M.J.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12674
Subject(s) - meloxicam , etoricoxib , medicine , cyclooxygenase , provocation test , culprit , pharmacology , piroxicam , hypersensitivity reaction , drug , antipyretic , anesthesia , gastroenterology , analgesic , enzyme , pathology , biochemistry , chemistry , alternative medicine , myocardial infarction
Summary Background Hypersensitivity to nonsteroidal anti‐inflammatory drugs ( NSAID s) can affect children, with the mechanism proposed being inhibition of the cyclooxygenase enzyme‐1 ( COX ‐1). In these patients nonchemically related NSAID s, including COX ‐2 inhibitors, can induce the reaction, hampering treatment of fever and inflammatory processes. Objectives To analyse retrospectively tolerance to etoricoxib, a selective COX ‐2 inhibitor, and to meloxicam, a preferential COX ‐2 inhibitor, in children with hypersensitivity to NSAID s. Methods Clinical records of children (aged 1–14 years) diagnosed with hypersensitivity reactions to NSAID s from January 2006 to January 2013 were included. The diagnosis was confirmed by oral drug provocation test ( DPT ) with the culprit NSAID s and acetylsalicylic acid ( ASA ). Tolerance to paracetamol, etoricoxib and meloxicam was also evaluated. Results The study included 41 children with a positive DPT with ASA and the culprit NSAID . DPT with paracetamol and etoricoxib was negative in all children, although two (4·9%) children developed a reaction after the administration of meloxicam. Conclusions These data indicate that both etoricoxib and meloxicam are good alternatives for treatment in older children with hypersensitivity to NSAID s.