Are drug provocation tests still necessary to test the safety of COX-2 inhibitors in patients with cross-reactive NSAID hypersensitivity?
Allergol. immunopatol
; 41(3): 181-188, mayo-jun. 2013. tab
Article
in English
| IBECS
| ID: ibc-112804
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
Background:
COX-2 inhibitors are safe alternatives in patients with cross-reactive non-steroidal anti-inflammatory drug (NSAID) hypersensitivity. These drugs are recommended to these patients after negative drug provocation tests (DPTs). However, cumulative data on encouraging results about the safety of COX-2 inhibitors in the majority of these patients bring the idea as to whether a DPT is always mandatory for introducing these drugs in all patients with cross-reactive NSAID hypersensitivity.Objective:
To document the safety of COX-2 inhibitors currently available and to check whether or not any factor predicts a positive response.Methods:
This study included the retrospective analysis of cases with cross-reactive NSAID hypersensitivity who underwent DPTs with COX-2 inhibitors in order to find safe alternatives. DPTs were single-blinded and placebo controlled.Results:
The study group consisted of 309 patients. COX-2 inhibitors were well tolerated in the majority of the patients [nimesulide 91.9%; meloxicam 90.2%; rofecoxib 94.9%; and celecoxib 94.9%)]. Twenty-five patients (30 provocations) reacted to COX-2 inhibitors. None of the factors were found be associated with positive response.Conclusion:
Our results suggest to follow the traditional DPT method to introduce COX-2 inhibitors for finding safe alternatives in all patients with cross-reactive NSAID hypersensitivity before prescription as uncertainty of any predictive factor for a positive response continues. However, these tests should be performed in hospital settings in which emergency equipment and experienced personnel are available (AU)
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Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Bronchial Provocation Tests
/
Drug Hypersensitivity
/
Cyclooxygenase 2 Inhibitors
Type of study:
Controlled clinical trial
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Allergol. immunopatol
Year:
2013
Document type:
Article
Institution/Affiliation country:
Ankara University/Turkey