1. Safety of meloxicam in aspirin-hypersensitive patients with asthma and/or nasal polyps. A challenge-proven study.
- Author
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Bavbek S, Dursun AB, Dursun E, Eryilmaz A, and Misirligil Z
- Subjects
- Adolescent, Adult, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Asthma complications, Cyclooxygenase Inhibitors adverse effects, Drug Hypersensitivity complications, Drug Hypersensitivity etiology, Humans, Meloxicam, Middle Aged, Nasal Polyps complications, Thiazines adverse effects, Thiazoles adverse effects, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Aspirin adverse effects, Asthma drug therapy, Cyclooxygenase Inhibitors therapeutic use, Nasal Polyps drug therapy, Thiazines therapeutic use, Thiazoles therapeutic use
- Abstract
Background: The anti-inflammatory actions of acetylsalicylic acid (ASA)/non-steroidal anti-inflammatory drugs (NSAIDs) are thought to be due to inhibition of COX-2, whereas the side effects such as gastric damage and aspirin-induced asthma are mediated through inhibition of COX-1. Therefore, a new class of drugs with COX-2 selectivity may be well tolerated by patients with ASA/NSAIDs hypersensitivity., Objective: We investigated whether subjects with asthma and/or nasal polyps (NP) and analgesic intolerance proven by oral ASA provocation test tolerated the selective COX-2 inhibitor, meloxicam., Methods: All subjects were first challenged with ASA using a 2-day, single-blind, placebo-controlled oral provocation test. Thereafter, the subjects showing positive response to ASA provocation underwent a single-blind, placebo-controlled challenge with a cumulative dose of 7.5 mg of meloxicam on 2 separate days. One and three fourths of the divided doses of placebo and the active drug were given at 1-hour intervals. Clinical symptoms, lung function, and blood pressure were monitored during these challenge protocols., Results: Twenty-one patients with asthma and/or NP (10 males and 11 females; mean age: 38.4 +/- 2.9 years) who reacted to ASA challenges were enrolled in the study. Response to ASA provocation was rhinitis + bronchospasm in 13, and extrabronchial reactions in 8 (isolated rhinitis in 3) patients. Mean PD(20) was 163.4 +/- 39.9 mg ASA among patients who reacted with bronchospasm to ASA. Only 1 patient reacted to meloxicam challenge at a cumulative dose of 7.5 mg., Conclusion: This study indicates that 7.5 mg of meloxicam is a safe alternative treatment for ASA-hypersensitive asthma and/or NP patients with proven hypersensitivity via oral ASA challenges., (Copyright 2007 S. Karger AG, Basel.)
- Published
- 2007
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