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Title: Safety of etoricoxib, a new cyclooxygenase 2 inhibitor, in patients with nonsteroidal anti-inflammatory drug-induced urticaria and angioedema. Author: Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A. Journal: Ann Allergy Asthma Immunol; 2005 Aug; 95(2):154-8. PubMed ID: 16136765. Abstract: BACKGROUND: The use of selective inhibitors of cyclooxygenase 2 (COX-2) has been shown to be safe in patients with aspirin-induced asthma. However, a few individuals with cutaneous reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) experience urticaria or angioedema when challenged with various coxibs. OBJECTIVE: To investigate the clinical tolerance of NSAID-sensitive individuals to the selective COX-2 inhibitors etoricoxib and celecoxib. METHODS: Patients with NSAID-induced urticaria or angioedema were challenged in a double-masked, placebo-controlled design protocol with etoricoxib (120 mg) and celecoxib (200 mg). Cutaneous, respiratory, and general symptoms; vital signs; and pulmonary function were monitored hourly for 3 hours. RESULTS: Fifty-eight patients (46 females and 12 males) with a mean +/- SD age of 31.7 +/- 14.1 years (range, 13-66 years) who showed urticaria or angioedema when challenged with NSAIDs were included in this study. A cutaneous clinical pattern was observed in 34 patients (59%), and a mixed pattern (cutaneous and respiratory) was seen in 24 (41%). Celecoxib provocation of 54 patients induced urticaria in 3, urticaria and angioedema in 2, and urticaria, rhinorrhea, and conjunctival erythema in 1 (reaction rate, 11.1%). Etoricoxib challenges performed in 56 patients induced urticaria in 3 and angioedema in 1 (reaction rate, 7.1%). CONCLUSIONS: These results confirm that most NSAID-sensitive individuals with cutaneous reactions to classic NSAIDs will tolerate specific COX-2 inhibitors, supporting the use of thesedrugs after careful oral provocation in such patients.[Abstract] [Full Text] [Related] [New Search]