Are drug provocation tests still necessary to test the safety of COX-2 inhibitors in patients with cross-reactive NSAID hypersensitivity?
Allergol. immunopatol
; 41(3): 181-188, mayo-jun. 2013. tab
Article
en En
| IBECS
| ID: ibc-112804
Biblioteca responsable:
ES1.1
Ubicación: BNCS
ABSTRACT
Background: COX-2 inhibitors are safe alternatives in patients with cross-reactive non-steroidal anti-inflammatory drug (NSAID) hypersensitivity. These drugs are recommended to these patients after negative drug provocation tests (DPTs). However, cumulative data on encouraging results about the safety of COX-2 inhibitors in the majority of these patients bring the idea as to whether a DPT is always mandatory for introducing these drugs in all patients with cross-reactive NSAID hypersensitivity. Objective: To document the safety of COX-2 inhibitors currently available and to check whether or not any factor predicts a positive response. Methods: This study included the retrospective analysis of cases with cross-reactive NSAID hypersensitivity who underwent DPTs with COX-2 inhibitors in order to find safe alternatives. DPTs were single-blinded and placebo controlled. Results: The study group consisted of 309 patients. COX-2 inhibitors were well tolerated in the majority of the patients [nimesulide: 91.9%; meloxicam: 90.2%; rofecoxib: 94.9%; and celecoxib: 94.9%)]. Twenty-five patients (30 provocations) reacted to COX-2 inhibitors. None of the factors were found be associated with positive response. Conclusion: Our results suggest to follow the traditional DPT method to introduce COX-2 inhibitors for finding safe alternatives in all patients with cross-reactive NSAID hypersensitivity before prescription as uncertainty of any predictive factor for a positive response continues. However, these tests should be performed in hospital settings in which emergency equipment and experienced personnel are available (AU)
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Colección:
06-national
/
ES
Base de datos:
IBECS
Asunto principal:
Pruebas de Provocación Bronquial
/
Hipersensibilidad a las Drogas
/
Inhibidores de la Ciclooxigenasa 2
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Allergol. immunopatol
Año:
2013
Tipo del documento:
Article