Celecoxib Tolerability in Patients with Hypersensitivity (Mainly Cutaneous Reactions) to Nonsteroidal Anti-Inflammatory Drugs

Viola, Marinella; Quaratino, Donato; Gaeta, Francesco; Caringi, Mario; Valluzzi, Rocco Luigi; Volpetti, Sabrina; Romano, Antonino

doi:10.1159/000085794

Cited by 22 publications

(15 citation statements)

References 81 publications

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“…7 None of the patients presented nasal polyps, reported histories of sinusitis, or had previously been exposed to parecoxib.…”

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 97%

“…4 For this reason, selective NSAIDs, which inhibit mainly the induced isoform of COX (COX-2) without affecting the arachidonic acid metabolism, can be considered good alternatives for patients with hypersensitivity to nonselective NSAIDs (which inhibit both COX-1 and COX-2). [4][5][6][7] However, in these patients-in particular those with cutaneous reactions-highly selective COX-2 inhibitors, such as rofecoxib, celecoxib, valdecoxib, and etoricoxib, also provoke hypersensitivity reactions with a frequency of 1.6%, 11.1%, 3.5%, and 7.1%, respectively, 8 although not all the studies on which these percentages are based were well controlled.…”

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 99%

“…5 Although LTs are important mediators of allergic inflammation, the association between the LTC4S polymorphism and the presence or severity of asthma has been controversial. [2][3][4][5][6][7][8] Here, we examined whether the LTC4S (A-444C) polymorphism is associated with the phenotype of asthma, especially with the exercise-induced asthma, and the severity of asthma.…”

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 99%

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Parecoxib tolerability in patients with hypersensitivity to nonsteroidal anti-inflammatory drugs

Viola

Quaratino

Volpetti

et al. 2006

Journal of Allergy and Clinical Immunology

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“…7 None of the patients presented nasal polyps, reported histories of sinusitis, or had previously been exposed to parecoxib.…”

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 97%

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 99%

Section: Parecoxib Tolerability In Patients With Hypersensitivity To mentioning

confidence: 99%

See 1 more Smart Citation

Parecoxib tolerability in patients with hypersensitivity to nonsteroidal anti-inflammatory drugs

Viola

Quaratino

Volpetti

et al. 2006

Journal of Allergy and Clinical Immunology

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“…Weak COX-1 inhibitors, such as paracetamol and partial inhibitors of both COX-1 and COX-2, such as nimesulide and meloxicam, can cross-react but generally only at high drug doses. Selective COX-2 inhibitors do rarely precipitate asthma and/or urticaria/angio-oedema and are generally (but not always) well tolerated (132).…”

Section: Aspirin and Other Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

193

197

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Anaesthesiologists administer several drugs while providing general anaesthesia. Many of these drugs can elicit adverse drug reactions that fall apart into two major types. First, reactions that are usually dose-dependent and related to the pharmacological properties of the drug and/or its metabolites. Second, reactions that are unrelated to the drug's pharmacological characteristics and that are less dose-dependent. These reactions comprise drug intolerance, idiosyncratic reactions and drug-induced immune-mediated allergic and nonimmune-mediated so-called pseudo-allergic or anaphylactoid reactions. The terms anaphylactic and anaphylactoid, however, have been used inconsistently in the literature. Therefore, the nomenclature task force set up by the European Academy of Allergy and Immunology (EAACI) has proposed that anaphylactic-type reactions should be reclassified into allergic anaphylaxis and nonallergic anaphylaxis. Allergic anaphylaxis being further subdivided in IgE-mediated and non-IgE-mediated reactions (1).The exact prevalence of anaphylaxis during anaesthesia is difficult to ascertain. The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2, 3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension. The degree of severity varies and does not allow differentiation between an IgE-mediated or non-IgE mediated reaction resulting from nonspecific mediator release (5). The mortality from these reactions is in the range from 3 to 6%, and an additional 2% of patients experience significant residual brain damage (4).Diagnosis of anaphylaxis during anaesthesia is not always straightforward. It can be hampered as a broad spectrum of different drugs can elicit heterogeneous allergic and nonallergic reactions with distinct and sometimes unclear pathological mechanisms. Problems are certainly compounded as multiple drugs need to be administered during general anaesthesia. In addition, nonanaesthesia related drugs or procedures (e.g. disinfection) are sometimes administered/performed in the perioperative period and can also be the cause of an allergic reaction.In addition, none of the available diagnostic tests demonstrates absolute accuracy. False-positive test Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds.However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done.This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the di...

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“…Nimesulide and meloxicam, preferential inhibitors of COX-2 (the induced isoform), can often be safely administered to NSAID-sensitive patients [7, 8]. The newer NSAIDs, such as rofecoxib, celecoxib, valdecoxib, parecoxib and etoricoxib, which selectively inhibit COX-2 without affecting the arachidonic acid metabolism [5], showed no clinical crossreactivity and can be considered good alternatives for patients with hypersensitivity to nonselective NSAIDs [5,9,10,11,12,13]. However, selective NSAIDs may provoke hypersensitivity reactions in a minority of patients, particularly in those with cutaneous reactions, with a frequency ranging from 1.6% for rofecoxib to 11.1% for celecoxib [14].…”

Section: Introductionmentioning

confidence: 99%

Etoricoxib Tolerability in Patients with Hypersensitivity to Nonsteroidal Anti-Inflammatory Drugs

Viola¹,

Quaratino²,

Gaeta³

et al. 2007

Int Arch Allergy Immunol

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Background: Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly observed, particularly among patients with chronic urticaria or asthma. The identification of a safe and reliable alternative is a frequent problem in clinical practice. Our aim was to investigate the clinical tolerability of etoricoxib, a new selective cyclooxygenase-2 inhibitor, in a group of patients with well-established NSAID hypersensitivity. Methods: We assessed 31 adults (21 women and 10 men) who reported one or more adverse reactions to NSAIDs, manifested as cutaneous, respiratory or anaphylactic symptoms. Sixteen of them reported reactions to a single NSAID (single reactors) and 15 to more than one NSAID (multiple reactors); the most frequently involved drug was acetylsalicylic acid. First, each patient underwent allergologic tests (skin and/or oral challenge tests) with culprit NSAIDs and then tolerability tests with increasing doses of etoricoxib up to 120 mg. All challenges were performed under single-blind, placebo-controlled conditions. Results: NSAID hypersensitivity was diagnosed in all 31 patients: 3 displayed positive results to pyrazolone skin tests and the other 28 to challenges with culprit NSAIDs. None reacted to either placebos or etoricoxib. Conclusions: Etoricoxib seems to be a safe alternative for patients with well-demonstrated NSAID hypersensitivity.

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Celecoxib Tolerability in Patients with Hypersensitivity (Mainly Cutaneous Reactions) to Nonsteroidal Anti-Inflammatory Drugs

Cited by 22 publications

References 81 publications

Parecoxib tolerability in patients with hypersensitivity to nonsteroidal anti-inflammatory drugs

Parecoxib tolerability in patients with hypersensitivity to nonsteroidal anti-inflammatory drugs

Anaphylaxis during anaesthesia: diagnostic approach

Etoricoxib Tolerability in Patients with Hypersensitivity to Nonsteroidal Anti-Inflammatory Drugs

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