Open AccessTolerance to alternative cyclooxygenase‐2 inhibitors in nonsteroidal anti‐inflammatory drug hypersensitive patients
Author(s) -
Malskat Wendy SJ,
Knulst André C,
BruijnzeelKoomen Carla AFM,
Röckmann Heike
Publication year - 2013
Publication title -
clinical and translational allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.979
H-Index - 37
ISSN - 2045-7022
DOI - 10.1186/2045-7022-3-20
Subject(s) - medicine , cyclooxygenase , nonsteroidal , drug , pharmacology , antiinflammatory drug , anti inflammatory , intensive care medicine , enzyme , biochemistry , chemistry
Background Non‐steroidal anti‐inflammatory drugs (NSAIDs) frequently cause adverse drug reactions. Many studies have shown that drugs which selectively inhibit the cyclooxygenase‐2 enzyme (COX‐2) are safe alternatives in the majority of patients. However, hypersensitivity reactions to COX‐2 inhibitors have been published. Hardly any data are available regarding the safety of alternatives in case of COX‐2 inhibitor hypersensitivity. We aimed to investigate the tolerance to COX‐2 inhibitors in patients with non‐selective NSAID hypersensitivity. Furthermore, in COX‐2 hypersensitive patients tolerance of a second COX‐2 inhibitor was investigated. Methods We retrospectively analyzed 91 patients with proven non‐selective NSAID hypersensitivity that underwent oral challenges with a COX‐2 inhibitor. Patients with intolerance to the first challenged COX‐2 inhibitor received a second challenge with a different COX‐2 inhibitor. Results 19 out of 91 (21%) patients had a positive reaction to the first oral challenge with a COX‐2 inhibitor. 14 of them underwent a second challenge with a different COX‐2 inhibitor and 12 (86%) did not react. Conclusions A relatively high percentage (21%) of the non‐selective NSAID hypersensitive patients did not tolerate a COX‐2 inhibitor and oral challenge is advised prior to prescription of a COX‐2 inhibitor. For the majority of patients reacting to a COX‐2 inhibitor an alternative can be found.