Background:
Patients with
aspirin-sensitive
respiratory and skin
diseases experience
cross reactions to
all nonsteroidal
anti-inflammatory
drugs (NSAIDs) which
inhibit
cyclooxigenase (COX)
enzymes. The need to
identify an
alternative drug
that is safe and
reliable is a common
problem in clinical
practice.
Objective:
The aim of this
study was to test
the tolerability of
meloxicam in NSAID-sensitive
patients.
Methods:
Between January 2005
and February 2006 we
performed single-blind
oral challenge tests
with meloxicam in
NSAID-intolerant
patients, exposing
them first to
placebo and then,
after 30 minutes, to
the first dose of
meloxicam (7.5 mg).
After 30 minutes, if
no response appeared,
the last dose of
meloxicam (15 mg)
was given, for a
total accumulated
dose of 22.5 mg. The
test was considered
positive if
urticaria, erythema,
and/or angioedema
appeared.
Results: We
tested 114 patients:
36% men and 64%
women whose mean age
was 45.81 years.
Meloxicam was well
tolerated in 109 of
the 114 patients
(95.62%) and only 5
(4.38%) developed an
adverse reaction
(urticaria in all
cases).
Conclusion:
This study shows
that meloxicam can
be a good option for
NSAID-intolerant
patients: it was
safe for over 95% of
the patients and is
easier to obtain
than celecoxib or
etoricoxib. However,
we think that a
patient should be
tested in an allergy
unit before it is
prescribed.
Key Words:
Angioedema.
Meloxicam.
Nonsteroidal anti-inflammatory drugs.
Tolerance.
Urticaria. Drug
allergy. |