Long-term use and tolerability of cyclooxygenase-2 inhibitors in patients with analgesic intolerance

ÇELİK G. E., Erkekol F. Ö., BAVBEK S., Dursun B., Misirligil Z.

Annals of Allergy, Asthma and Immunology, vol.95, no.1, pp.33-37, 2005 (SCI-Expanded) identifier identifier


Background: Cyclooxygenase-2 (COX-2) inhibitors are reported to be well tolerated in patients with analgesic intolerance (AI). However, limited data are available about the long-term tolerability of these drugs. Objective: To determine the long-term tolerability of COX-2 inhibitors in patients with AI. Methods: Patients with AI who previously underwent single-masked, placebo-controlled oral provocation tests and were found to tolerate nimesulide, meloxicam, rofecoxib, or celecoxib were interviewed regarding the long-term use and tolerability of these drugs. Results: Of 87 patients, 61 (70%) had used the recommended COX-2 inhibitor(s). Of the 61 users, 54 (89%) tolerated the drug(s) well and 7 (11%) reported adverse events. Three patients reporting adverse events were rechallenged with the responsible COX-2 inhibitor, and their results were found to be negative. Conclusions: Long-term use of COX-2 inhibitors was tolerated well by most patients with AI, and placebo-controlled oral provocation tests, as a single test, seemed to predict tolerability. Furthermore, self-reported positive reactions in the long-term should also be confirmed with rechallenge tests for definite diagnosis.