Tolerability to new COX-2 inhibitors in NSAID-sensitive patients with cutaneous reactions

Borges, Mario Sánchez; Capriles‐Hulett, Arnaldo; Caballero‐Fonseca, Fernan; Pérez, Carlos

doi:10.1016/s1081-1206(10)62226-0

Cited by 100 publications

(44 citation statements)

References 12 publications

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“…In most studies, rofecoxib, celecoxib and etoricoxib are well tolerated by all patients (55). However, in some studies, celecoxib and rofecoxib induced skin reactions in 7-33% of patients submitted to controlled challenges (57). These data strongly suggest that, before prescription of alternative treatment for pain and inflammation, a placebo-controlled provocation test should be performed.…”

Section: Management Of Patients With Cutaneous Nsaid Hypersensitivitymentioning

confidence: 99%

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Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Kowalski

Makowska

Blanca³

et al. 2011

Allergy

391

366

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Following the first description of hypersensitivity reaction to aspirin (ASA) by Hirschberg in 1902, several types of hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) have been described. The NSAIDs-induced hypersensitivity reactions involve different mechanisms and present a wide range of clinical manifestations from anaphylaxis AbstractNonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21-25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hypersensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/ or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs.

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Section: Management Of Patients With Cutaneous Nsaid Hypersensitivitymentioning

confidence: 99%

“…Thus, weak COX inhibitors can be recommended as alternative drugs, if their tolerance is confirmed by a negative challenge (57). A successful desensitization to aspirin in patients with NSAIDs hypersensitivity without underlying chronic skin disorder has not been reported (59).…”

Section: Managementmentioning

confidence: 99%

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Kowalski

Makowska

Blanca³

et al. 2011

Allergy

391

366

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“…Olguların siklooksigenaz-2 inhibitörlerini güvenilir olarak kullanabileceği belirtilmekle birlikte, bu ajanlarla da nadiren kutan reaksiyon gelişebildiği gözlenmiştir. Bu bağlamda özellikle celecoxib'in diğer siklooksigenaz-2 inhibitörlerine göre daha riskli olduğu, rofecoxib'in ise daha güvenilir göründüğü bildirilmiştir 44 . LT antagonistlerinin SDAİİ'a bağlı ekzaserbasyonları önleyebileceği savunulmuşsa da, son yayınlarda etkinliğinin tartışmalı olduğu ileri sürülmüştür.…”

Section: Belirli Medikasyonlarla İlişkili Olan Anjiyoödem Tabloları: unclassified

Angioedema: Diagnosis and treatment approaches

Güneş¹,

Akarsu²

2013

TURKDERM

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ÖzetAnjiyoödem (AE) deri ve/veya mukozaların ani başlangıçlı geçici lokalize ödemi olarak tanımlanır. Bu şişme tablosu subkutan ve submukozal dokulardaki postkapiller venüllerin geçirgenliğini arttıran çeşitli vazoaktif mediyatörlerin aracılığıyla oluşan interstisyal ödem sonucunda meydana gelir. Deriye lokalize olduğunda asimetrik, gode bırakmayan, yer çekimiyle yer değiştirmeyen ve bazen ağrılı olabilen şişme ile karakterizedir. Bununla birlikte laringeal ödem ve barsak tutulumu gibi mukozal ataklar şiddetli rahatsızlığa ve hayati tehlike oluşturan semptomlara yol açabilir. Çeşitli AE formları arasında C1 inhibitör geninin disfonksiyonu veya eksikliği ile ilişkili AE (klasik herediter AE tipleri ve edinsel AE), allerjik AE, ilaçlarla ilişkili AE (steroid dışı antiinflamatif ilaçlara bağlı AE, anjiyotensin dönüştürücü enzim inhibitörlerine bağlı AE), idiyopatik AE ve yakın zamanda tanımlanan tip 3 herediter AE bulunmaktadır. Bu değişik AE formlarında örtüşen semptomlar olabilmekle birlikte bazı özgün klinik ve öykü özellikleri yanında eşlik eden ürtikaryanın varlığı ayırıcı tanıda yardımcı olabilir. AE benzeri tabloları dışlamak, tetikleyici faktörleri saptamak ve uzaklaştırmak, atakları erken farketmek ve gerekli olduğunda agresif solunum yolu açıklığını sağlamak başarılı tedavinin temelini oluşturur. Bu makalede AE'nın sık ve nadir görülen formları yanında klinik semptomları, ayırıcı tanıları ve tedavi yaklaşımları derlenmiştir. (Türk derm 2013; 47: 7-18) Anah tar Ke li me ler: Anjiyoödem, tanı, ayırıcı tanı, tedavi Sum maryAngioedema (AE) is defined as sudden, localized and transient swelling of the skin and/or mucous membranes. This swelling condition is a result of interstitial edema from vasoactive mediators increasing the permeability of postcapillary venules of the subcutaneous and submucosal tissues. When localized to the skin, it presents as asymmetric, nonpitting, nondependent, and occasionally painful edema. However, mucosal attacks, such as laryngeal edema and bowel involvement can produce severe discomfort and life-threatening symptoms. There are several forms including those involving dysfunction or depletion of the C1-inhibitor gene (classical hereditary AE types and acquired AE), allergic AE, drug-induced AE (nonsteroidal anti-inflammatory drug-induced AE, angiotensin converting enzyme inhibitor-induced AE), idiopathic and a recently described form, HAE type 3. These various forms of AE have overlapping symptoms, but some unique clinical and historical features as well as presence of accompanying urticaria can aid in the differential diagnosis. The key to successful management is to rule out conditions that masquerade as AE, detection and avoidance of triggers, early recognition of attacks, and aggressive airway management when warranted. In this article, common and rare forms as well as clinical symptoms, differential diagnosis, and treatment approaches for AE are reviewed. (Turkderm 2013; 47: 7-18

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“…The anti-in°ammatory and analgesic e®ect of selective COX-2 inhibitors are similar to classic NSAIDs with a lower incidence of adverse e®ects. Borges et al [129] investigated tolerance to COX-2 inhibitors in patients with cutaneous symptoms attributable to classic NSAIDs. In NSAID sensitive patients with urticaria or angioedema some COX-2 inhibitors such as rofecoxib are relatively safe.…”

Section: Safety Studies Of Cox-2 Inhibitorsmentioning

confidence: 99%

Heterocyclic inflammation inhibitors

et al. 2004

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Non steroidal anti-in®ammatory drugs are the most widely used medicines for relief of pain. These drugs have some side e¬ects, particularly toxicity in the gastrointestinal tract and kidneys. Various approaches have been used for obtaining safer anti-in®ammatory drugs. In this review we have summarized the recent developments in the following areas; (i) Mode of action of NSAIDs, (ii) Role of COX-1 & COX-2 in in®ammation, (iii) Di¬erent approaches used to improve gastric tolerance i.e chemical manipulation, formulation & co-administration, development of non speci c (COX

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Tolerability to new COX-2 inhibitors in NSAID-sensitive patients with cutaneous reactions

Cited by 100 publications

References 12 publications

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Angioedema: Diagnosis and treatment approaches

Heterocyclic inflammation inhibitors

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