kathi

Title: Safe Full-Dose One-Step Nabumetone Challenge in Patients with
Nonsteroidal Anti-Inflammatory Drug Hypersensitivity
Author(s): Ronit Confino-Cohen MD ; Arnon Goldberg MD
Source: Allergy and Asthma Proceedings Volume: 24 Number: 4 Page:
281 -- 284
Publisher: OceanSide Publications, Inc
Abstract: Aspirin and all nonsteroidal anti-inflammatory drugs (NSAIDs)
are a chemically heterogeneous group of compounds that share the ability
to inhibit the enzyme cyclooxygenase (COX). This inhibitory effect,
especially of COX-1, is suggested as the mechanism underlying
NSAID-induced hypersensitivity reactions. In this study, we evaluated
the safety and convenience of a single fulldose challenge with
nabumetone, a selective COX-2 inhibitor, in patients with
hypersensitivity to nonselective NSAIDs (nsNSAIDs). Twenty-four subjects
with a history of hypersensitivity reactions to at least two different
ns-NSAIDs on two different occasions were enrolled in the study. The
patients were otherwise healthy and did not suffer from NSAID- or
aspirin-induced asthma or urticaria. All subjects were orally challenged
by a single full dose (1000 mg) of nabumetone, monitored closely in the
hospital for the next 4 hours and contacted by telephone the next
morning and 3-12 months afterward. Twenty-two patients tolerated
nabumetone without any reaction during and after the challenge. One
patient had a single urticarial lesion and one patient reported mild
pruritus without objective signs, both of which resolved spontaneFrom
ously. Thir**** patients, including the patient who responded with
pruritus to the challenge, used nabumetone on several occasions during
the follow-up period without any adverse reaction. Our study shows that
in patients with a history of aspirin- and nsNSAID-induced
hypersensitivity reaction, a rapid one-step challenge with nabumetone
was well tolerated. These initial data support the possibility that a
single full dose of nabumetone can be tried as a safe alternative in
most patients with a hypersensitivity reaction to ns-NSAIDs.
© 2003 OceanSide Publications, Inc

http://gi****o.ingentaselect.com/vl=5380161/cl=12/nw=1/rpsv/cw/ocean/10885412/v24n4/s9/p281