Quiralte Joaquín, Sáenz de San Pedro Blanca, Florido J José Fernando
Allergy Unit, Hospital Universitario Ciudad de Jaén, Spain.
Ann Allergy Asthma Immunol. 2002 Jul;89(1):63-6. doi: 10.1016/s1081-1206(10)61912-6.
Controlled oral challenge with nonsteroidal anti-inflammatory drugs (NSAIDs) is the only definite way to diagnose the different clinical manifestations of NSAID sensitivity.
To evaluate the safety of selective cyclooxygenase-2 inhibitor rofecoxib in a patient population with NSAID-induced skin reactions.
We prospectively conducted single-blind, placebo-controlled, oral challenges (SBPCOCs) with rofecoxib in 15 patients with challenge-proven NSAID-induced cutaneous reactions.
Fifteen patients (9 men and 6 women, ranging in age from 14 to 60 years) had positive SBPCOC response to at least one of the following NSAIDs: aspirin (in 46.7% of cases), nimesulide (in 40% of cases), and diclofenac (in the remaining 13.3% of cases). During controlled challenges, 8 patients (53.3%) had urticaria (1 of them with associated angioedema); 6 (40%) had facial angioedema; and 1 (6.6%) had nonurticarial rash. Controlled oral challenge with rofecoxib were well tolerated in all patients.
Rofecoxib did not cross-react with aspirin and other NSAIDs in patient with NSAID-induced skin reactions. A tolerance observed to this drug during SBPCOCs will indicate a safe alternative in this patient-group.
使用非甾体抗炎药（NSAIDs）进行口服激发试验是诊断NSAID敏感性不同临床表现的唯一明确方法。
评估选择性环氧化酶-2抑制剂罗非昔布在NSAID诱导的皮肤反应患者群体中的安全性。
我们前瞻性地对15例经激发试验证实有NSAID诱导的皮肤反应的患者进行了罗非昔布单盲、安慰剂对照的口服激发试验（SBPCOCs）。
15例患者（9例男性和6例女性，年龄在14至60岁之间）对以下至少一种NSAIDs的SBPCOC反应呈阳性：阿司匹林（46.7%的病例）、尼美舒利（40%的病例）和双氯芬酸（其余13.3%的病例）。在对照激发试验期间，8例患者（53.3%）出现荨麻疹（其中1例伴有血管性水肿）；6例（40%）出现面部血管性水肿；1例（6.6%）出现非荨麻疹性皮疹。所有患者对罗非昔布的口服激发试验耐受性良好。
在NSAID诱导的皮肤反应患者中，罗非昔布与阿司匹林及其他NSAIDs无交叉反应。在SBPCOCs期间观察到对该药物的耐受性表明在该患者群体中它是一种安全的替代药物。
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