Selective cyclo-oxygenase 2 inhibitor in patients with aspirin-induced asthma

Yoshida, Satoshi; Ishizaki, Yuko; Onuma, Kazuya; Shoji, Tatsuhiro; Nakagawa, Hiroshi; Amayasu, Hideaki

doi:10.1067/mai.2000.110926

Cited by 59 publications

(30 citation statements)

References 5 publications

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“…Celecoxib was also well tolerated by the 5 patients with histories of anaphylaxis after intake of NSAIDs. Our results confirm those of the other studies which have assessed the tolerability of celecoxib in NSAID-sensitive patients with respiratory or anaphylactic symptoms [18, 19, 21,23,24,25,26,27,28,29,30]. On the other hand, celecoxib had a 1.1% (1 out of 92) rate of cross-reactivity in patients with exclusively cutaneous reactions to NSAIDs.…”

Section: Discussionsupporting

confidence: 82%

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

Viola¹,

Quaratino

Gaeta³

et al. 2005

Int Arch Allergy Immunol

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Background: Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly observed in clinical practice, particularly among patients with chronic urticaria or asthma. The identification of a safe and reliable alternative is a frequent problem for both general practitioners and allergists. Methods: We assessed 120 patients (83 women and 37 men) who had experienced adverse reactions to one or more NSAIDs; 64 (53.3%) of them had reacted to only one NSAID (single reactors) and 56 (46.7%) to multiple NSAIDs (multiple reactors). Among our subjects, 76.7% reported cutaneous reactions, 8.3% respiratory symptoms, 10.8% both cutaneous and respiratory symptoms, and 4.2% anaphylaxis. All patients were subjected to a single-blind, placebo-controlled oral challenge with two different doses of celecoxib (50 + 150 mg 1 h later = cumulative dose of 200 mg). Results: None of the patients reacted to the placebo and only one (0.8%) suffered a reaction (urticaria) after the second dose of celecoxib. Conclusions: Celecoxib showed a 98.9% rate of tolerability in the 92 patients with exclusively cutaneous reactions and was well tolerated by all 28 subjects with NSAID-related respiratory or anaphylactic symptoms.

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Section: Discussionsupporting

confidence: 82%

“…On the other hand, most studies assessing celecoxib tolerability in NSAID-sensitive subjects were performed in samples smaller than 50 patients and showed variable results in those subjects who had suffered cutaneous reactions [13,18,19,20,21,22,23,24,25,26,27,28,29,30]. …”

Section: Introductionmentioning

confidence: 99%

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

Viola¹,

Quaratino

Gaeta³

et al. 2005

Int Arch Allergy Immunol

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“…New, very selective COX-2 inhibitors, rofecoxib, celecoxib and valdecoxib, have been marketed in many countries. Thereafter, they have been the subject of several studies in ASA-/NSAID-hypersensitive patients [7,8,9,10,11]. These studies demonstrated the safety of these drugs particularly in patients with ASA-/NSAID-hypersensitive asthma.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the history of patients is not always reliable enough for the diagnosis of analgesic intolerance (AI), and the only way to accurately diagnose intolerance is through a provocative challenge test [20]. However, a confirmatory provocation test with the culprit drug has been used in only a few studies evaluating the safety of selective COX-2 inhibitors in patients with AI [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Therefore, we performed this study to determine the tolerability of a preferential COX-2 inhibitor, meloxicam, in ASA-/NSAID-hypersensitive asthmatics and/or patients with nasal polyposis (NP) in whom ASA hypersensitivity was demonstrated by an oral ASA provocation test described by Nizankowska et al [22].…”

Section: Introductionmentioning

confidence: 99%

Safety of Meloxicam in Aspirin-Hypersensitive Patients with Asthma and/or Nasal Polyps

Bavbek

Dursun²,

Dursun³

et al. 2006

Int Arch Allergy Immunol

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Background: The anti-inflammatory actions of acetylsalicylic acid (ASA)/non-steroidal anti-inflammatory drugs (NSAIDs) are thought to be due to inhibition of COX-2, whereas the side effects such as gastric damage and aspirin-induced asthma are mediated through inhibition of COX-1. Therefore, a new class of drugs with COX-2 selectivity may be well tolerated by patients with ASA/NSAIDs hypersensitivity. Objective: We investigated whether subjects with asthma and/or nasal polyps (NP) and analgesic intolerance proven by oral ASA provocation test tolerated the selective COX-2 inhibitor, meloxicam. Methods: All subjects were first challenged with ASA using a 2-day, single-blind, placebo-controlled oral provocation test. Thereafter, the subjects showing positive response to ASA provocation underwent a single-blind, placebo-controlled challenge with a cumulative dose of 7.5 mg of meloxicam on 2 separate days. One and three fourths of the divided doses of placebo and the active drug were given at 1-hour intervals. Clinical symptoms, lung function, and blood pressure were monitored during these challenge protocols. Results: Twenty-one patients with asthma and/or NP (10 males and 11 females; mean age: 38.4 ± 2.9 years) who reacted to ASA challenges were enrolled in the study. Response to ASA provocation was rhinitis + bronchospasm in 13, and extrabronchial reactions in 8 (isolated rhinitis in 3) patients. Mean PD₂₀ was 163.4 ± 39.9 mg ASA among patients who reacted with bronchospasm to ASA. Only 1 patient reacted to meloxicam challenge at a cumulative dose of 7.5 mg. Conclusion: This study indicates that 7.5 mg of meloxicam is a safe alternative treatment for ASA-hypersensitive asthma and/or NP patients with proven hypersensitivity via oral ASA challenges.

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“…While aspirin-sensitive asthma patients show hyperreactivity against inhaled Cys-LTE 4 , Cys-LTC 4 and Cys-LTD 4 do not evoke the same hyperreactivity. Clinical studies have shown that inhibition of COX 1 enzyme triggers asthma attacks unlike COX 2 inhibition [18,19] .…”

Section: Discussionmentioning

confidence: 99%

Cysteinyl Leukotriene Receptor Expression in Aspirin-Sensitive Nasal Polyposis Patients

Özen

Mumbuç²,

Sarı

et al. 2007

ORL

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Background: The aim of this study was to detect cysteinyl leukotriene (Cys-LT) receptors in aspirin-sensitive nasal polyposis patients, and compare them with nasal polyposis and chronic rhinosinusitis patients without aspirin sensitivity. Methods: The formalin-fixed, paraffin-embedded tissue blocks of a total of 52 patients undergoing endoscopic sinus surgery were reviewed by an experienced head and neck pathologist. Of these 52 cases, there were 22 nasal polyposis cases with aspirin sensitivity, 15 nasal polyposis cases without aspirin sensitivity and 15 chronic rhinosinusitis cases without aspirin sensitivity. Immunohistochemical analyses for Cys-LT₁ receptors were performed with polyclonal rabbit antibody. Results: Eosinophil receptor intensity levels were 27.68, 21.67, and 14.40, respectively. This was statistically insignificant (p <0.089). Mast cell receptor intensity levels were 8.41, 5.27, and 4.27, respectively. In the aspirin-sensitive group, mast cell receptor intensity was significantly higher when compared to the nasal polyposis and chronic rhinosinusitis group (p < 0.0001 and p < 0.0001, respectively). The difference in Cys-LT₁ receptor immunoreactivity in both eosinophils and mast cells among the 3 groups was also found to be statistically significant (p < 0.001). Conclusions: Our study revealed that nasal polyps of aspirin-sensitive patients were infiltrated with eosinophils and mast cells, Cys-LT₁ receptor proportions in these inflammatory cells were found to be higher and Cys-LT₁ receptor immunoreactivity in eosinophils and mast cells was increased.

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Selective cyclo-oxygenase 2 inhibitor in patients with aspirin-induced asthma

Cited by 59 publications

References 5 publications

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

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

Safety of Meloxicam in Aspirin-Hypersensitive Patients with Asthma and/or Nasal Polyps

Cysteinyl Leukotriene Receptor Expression in Aspirin-Sensitive Nasal Polyposis Patients

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