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Original Article
 

Tolerability to Etoricoxib in Patients With Aspirin-Exacerbated Respiratory Disease
 

D Koschel,1 C Ninck Weber,1 G Höffken1,2

1Department of Pulmonary Diseases, Fachkrankenhaus Coswig, Centre for Pulmonary Diseases and Thoracic Surgery, Coswig, Germany
2Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany

J Investig Allergol Clin Immunol 2013; Vol. 23(4): 275-280
 

 Abstract


Background: The use of selective cyclooxygenase (COX) 2 inhibitors as an alternative to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested for patients with aspirin-exacerbated respiratory disease (AERD).

Objective: To evaluate tolerability to etoricoxib, a second-generation COX-2 inhibitor with high in vitro selectivity for COX-2 in patients with AERD.

Methods: We conducted a retrospective review of patients with suspected aspirin intolerance seen between October 2007 and April 2012. Single-blind, placebo-controlled oral challenges with increasing doses of aspirin and etoricoxib were performed on 3 different days.

Results: Of 262 patients with suspected aspirin intolerance, 248 underwent challenge testing with aspirin and 122 (49.2%) showed positive test results. In 104 of these aspirin-sensitive patients, etoricoxib was tested as an alternative drug and was tolerated in all but 3 (2.9%), who developed a positive asthmatic reaction.

Conclusions: The highly selective COX-2 inhibitor etoricoxib was tolerated in most but not all patients tested. An oral provocation test is therefore recommended before prescribing etoricoxib for patients with AERD.

Key words: Aspirin-exacerbated respiratory disease. Asthma. COX-II inhibitor. Etoricoxib. Hypersensitivity