Tolerability of Selective Cyclooxygenase Inhibitor, Celecoxib, in Patients with Analgesic Intolerance

Intolerance reactions to acetyl salicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of COX-1 enzyme. Therefore, drugs that selectively inhibit COX-2 enzyme may be safe in these subjects. In this study, we evaluated the tolerability of celecoxib,...

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Bibliographic Details
Published in:The Journal of asthma 2005-01, Vol.42 (2), p.127-131
Main Authors: Çelik, Gülfem, Pa ao lu, Gülden, Bavbek, Sevim, Abado lu, Öznur, Dursun, Berna, Mungan, Dil ad, M s rl gil, Zeynep
Format: Article
Language:English
Subjects:
Adult
Anaphylaxis - chemically induced
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Aspirin - adverse effects
Aspirin-induced asthma
Bronchial Spasm - chemically induced
Celecoxib
Cyclooxygenase 2
Cyclooxygenase 2 Inhibitors
Cyclooxygenase Inhibitors - therapeutic use
Drug Hypersensitivity
Female
Humans
Hypersensitivity reaction
Male
Membrane Proteins
Oral provocation tests
Prostaglandin-Endoperoxide Synthases - drug effects
Pseudoallergic reactions
Pyrazoles - therapeutic use
Rhinitis - chemically induced
Single-Blind Method
Sulfonamides - therapeutic use
Treatment Outcome
Urticaria - chemically induced
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Summary:Intolerance reactions to acetyl salicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) are common and caused by inhibition of COX-1 enzyme. Therefore, drugs that selectively inhibit COX-2 enzyme may be safe in these subjects. In this study, we evaluated the tolerability of celecoxib, a selective COX-2 inhibitor, in patients with analgesic intolerance. The eligible study population consisted of patients with a history of urticaria/angioedema, naso-ocular symptoms, bronchospasm, and/or anaphylactoid reaction induced by ASA and/or NSAIDs. A single-blind, placebo-controlled oral challenge test was performed in the hospital setting. On 2 separate days, ¼ and ¾ divided doses of placebo and celecoxib (Celebrex 200 mg, Pfizer, Turkey) were given with 2-hour intervals. Seventy-five subjects (mean age: 38.2 ± 1.4 years; F:M: 55:20) were included in the study. Twenty-one subjects had asthma. No reaction was observed with placebo or celecoxib provocation. Although celecoxib seems to be a safe alternative drug in our study group, considering its serious adverse events reported in the literature, the drug should be recommended for patients with analgesic intolerance only after being tested by an experienced allergist.
ISSN:0277-0903
1532-4303
DOI:10.1081/JAS-51326