Short-term tolerability of morniflumate in patients with cutaneous hypersensitivity reactions to non-steroidal anti-inflammatory drugs.

Morniflumate is the morpholinoethyl ester of niflumic acid, a non-steroidal anti-inflammatory drug, derived from nicotinic acid. We studied 112 patients who had experienced cutaneous reactions after using non-steroidal anti-inflammatory drugs. Only two of all the patients who underwent an oral challenge with morniflumate had a positive result to the test. By demonstrating the low incidence of reactions to morniflumate through oral challenges, we suggest that patients with non-steroidal anti-inflammatory drug hypersensitivity may tolerate this drug which would therefore be a useful alternative.

Diagnosis of latex allergy: the importance of hev B 11.

We present the cases of 5 patients with a positive clinical history of cutaneous symptoms due to contact with latex products. A latex allergological assessment was made through skin prick tests (SPTs) both with commercial latex extracts and extemporaneous glove extracts, and serum-specific IgE to latex and glove-use tests. In addition, serum-specific IgE to recombinant allergens for Hevea brasiliensis was dosed. Molecular diagnostics in association with the glove-use test and, to a lesser extent, the SPTs with glove eluate are useful diagnostic tests to confirm the diagnosis of latex allergy in patients with mucocutaneous symptoms.

Acquired angioedema with C1 inhibitor deficiency associated with anticardiolipin antibodies.

Acquired angioedema (AAE) with C1 inhibitor deficiency is often associated to B cell lymphoproliferative disorders or autoimmune diseases. We report a case of AAE associated with IgM anti-cardiolipin antibodies, with frequent edematous attacks, that disappeared completely after a slight immunosuppression and danazol therapy.

Tomato atopy patch test in adult atopic dermatitis: diagnostic value and comparison among different methods.

Tomato atopy patch test in adult atopic dermatitis.

Long-term tolerability of etoricoxib in patients with previous reactions to non-steroidal anti-inflammatory drugs.

Non-steroidal anti-inflammatory drugs frequently cause adverse reactions. This retrospective study was based on analysis of the data obtained from interviews conducted with 173 patients, who underwent and tolerated a challenge test with etoricoxib (a selective cyclooxigenase 2 enzyme inhibitor). Only one of 82 patients who were treated with etoricoxib reported reactions. We can conclude that etoricoxib shows a high long-term tolerability in patients with non-steroidal anti-inflammatory drug hypersensitivity.

Parecoxib as an alternative in COX-2 hypersensitivity.

The group of non-steroidal anti-inflammatory drugs (NSAIDs) is commonly involved in hypersensitivity reactions. In clinical practice the physician is often faced with the need to choose an alternative anti-inflammatory agent for a patient who has suffered a hypersensitivity reaction to a NSAID. The most common approach to choosing the safest NSAID is to perform a challenge test. Parecoxib is the first injectable COX-2 selective inhibitor indicated for the treatment of acute postoperative pain. The authors report the case of a patient with a history of cutaneous adverse reactions to different classes of NSAIDs, including selective COX-2 inhibitors, who underwent and tolerated challenge with parecoxib.

Once daily levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria.

Levocetirizine is the pharmacologically active enantiomer of cetirizine. It is a potent histamine H-1 receptor antagonist with anti-inflammatory and antiallergic properties. The review analyses the levocetirizine's properties in terms of safety and efficacy both in allergic rhinitis and urticarioid syndromes.

Double-blind, placebo-controlled study of sublingual immunotherapy in patients with latex-induced urticaria: a 12-month study.

BACKGROUND: Natural rubber latex (NRL) allergy is a worldwide problem. Although prevention is sufficient to reduce sensitization, prolonged avoidance is needed to prevent resensitization or adverse reactions on re-exposure. OBJECTIVES: This double-blind, placebo-controlled study was conducted to determine the efficacy of sublingual immunotherapy (SLIT) with latex. METHODS: Forty patients with NRL allergy were enrolled. At diagnosis, 30 presented urticaria and 10 asthma. Patients were evaluated on their clinical history and an allergological assessment: skin prick test with latex extract, serum-specific IgE and provocation tests. Patients were subdivided by complaint (asthma or urticaria), and randomized to receive SLIT with latex extract (ALK-Abelló, Lainate, Milan, Italy) or placebo. RESULTS: The evaluable population consisted of 35 patients, 18 treated with SLIT and 17 with placebo. The results show that 12 months of SLIT improved the symptoms score and reduced the medication score in all subjects. The subjective evaluation was corroborated by improved bronchial and glove provocation test results. The latex-specific IgE levels increased slightly in the SLIT group, and skin sensitization was reduced at the end of the trial in all the patients treated with SLIT. The immunotherapy was not complicated by any severe adverse reactions. CONCLUSIONS: This is the first double-blind, placebo-controlled evaluation of the efficacy of SLIT with latex extract conducted in adult patients allergic to NRL. SLIT with latex can be proposed for subjects with latex allergy, especially those for whom complete avoidance of latex exposure may be very difficult or even impossible. More studies are needed to evaluate the efficacy of SLIT in the treatment of subjects with latex allergy who are sensitized to inhalant allergens.

Desloratadine in combination with montelukast suppresses the dermographometer challenge test papule, and is effective in the treatment of delayed pressure urticaria: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Delayed pressure urticaria (DPU) comes under the heading of physical urticaria. Characteristically itchy, tender or painful weals occur at sites of local pressure including the waistband, soles of the feet and palms of the hands. Lesion onset is typically 3-12 h after the application of pressure, and lesions may persist for more than 24 h. The treatment of DPU is often unsatisfactory. OBJECTIVES: To determine the efficacy of desloratadine and montelukast in the treatment of DPU. METHODS: The study was conducted in 36 subjects affected by DPU. A challenge test with a dermographometer was administered to confirm the diagnosis. After diagnosis, patients were randomized to receive the following treatment once daily for 2 weeks: (i) oral desloratadine 5 mg plus oral placebo; (ii) oral desloratadine 5 mg plus montelukast 10 mg; and (iii) oral placebo alone. RESULTS: At rechallenge, patients from the treatment groups (desloratadine plus montelukast group and desloratadine alone group) demonstrated a significant reduction in mean diameter of papules after 70 s of pressure compared with the placebo group (P < 0.05). Moreover, patients treated with desloratadine plus montelukast showed a significant reduction in mean diameter of papules at 70 s of pressure compared with those treated with desloratadine alone (P < 0.05). In addition, the combination was effective in improving clinical parameters (erythema, oedema and pruritus, and number of separate urticarial episodes). CONCLUSIONS: This study has demonstrated that both desloratadine alone and desloratadine plus montelukast administered once daily yield improvements with respect to the baseline assessment, regarding the suppression of the dermographometer challenge test papule and clinical improvement of urticaria. However, the combination of desloratadine and montelukast was shown to be more efficacious and may therefore be proposed in patients with DPU, in order to avoid corticosteroid therapy.