Some COX-2 inhibitors safe in NSAID-intolerant patients

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Some cyclooxygenase-2 (COX-2) inhibitors are relatively safe in patients who are intolerant to conventional nonsteroidal anti-inflammatory drugs, according to a report in the September issue of the Annals of Allergy, Asthma and Immunology.

Dr. Mario Sבnchez Borges, of Centro Mיdico-Docente La Trinidad in Caracas, Venezuela, and colleagues examined tolerance to COX-2 inhibitors in a single-blinded, placebo-controlled study of patients with angioedema or urticaria attributable to NSAIDs.

The researchers explain that 110 subjects collectively underwent 184 oral challenges with four COX-2 inhibitors. "Eighty-two patients (74.5%) were cross-reactors and 28 patients (25.4%) were single reactors," they note.

Of 75 patients challenged with nimesulide, 16 reacted (reaction rate 21.3%). Eight of 46 patients challenged with meloxicam reacted (RR 17.3%). To celecoxib, 10 of 30 patients had a positive test (RR 33.3%), but only one of 33 reacted to rofecoxib (RR 3.0%).

"Because the proportion of patients reacting to different COX-2 inhibitors is variable, there would still be the need for individual oral challenges to determine the tolerance of each patient to a particular drug," Dr. Borges and colleagues advise.

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