Celecoxib tolerability in patients with hypersensitivity (mainly cutaneous reactions) to nonsteroidal anti-inflammatory drugs

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. Copyright (C) 2005 S. Karger AG, Basel.