Szczeklik A, Nizankowska E, Dworski R
Dept of Allergy and Clinical Immunology, Copernicus Academy of Medicine, Cracow, Poland.
Eur Respir J. 1990 May;3(5):535-9.
Treatment of inflammatory diseases of asthmatics can be a serious problem since some patients show intolerance to aspirin and other non-steroidal, anti-inflammatory drugs that are cyclooxygenase inhibitors. Salicylates were believed to be well tolerated, but recent reports have demonstrated that diflunisal and salicylsalicylic acid can precipitate asthma attacks in aspirin-intolerant patients. This study was designed to determine the tolerance of choline magnesium trisalicylate (CMT), a nonacetylated salicylate with potent analgesic and anti-inflammatory activity, in 23 asthmatics with aspirin hypersensitivity confirmed by oral challenge. The study consisted of three phases: 1) patients received increasing doses (50-1,500 mg) of CMT under a single-blind protocol; 2) patients received either a placebo or CMT challenge in a double-blind, randomized, cross-over design; 3) patients received CMT at daily 3,000 mg doses for 1 week. Throughout the study, pulmonary function tests, peak nasal inspiratory flow, and serum salicylate and thromboxane B2 (TXB2) levels were monitored. Results showed no airway obstruction, nasal congestion or rhinorrhea after CMT. There was no significant decrease in serum TXB2 levels, indicating the absence of cyclooxygenase inhibition with CMT. We conclude that choline magnesium trisalicylate is a safe drug for treatment of different anti-inflammatory disorders in asthmatics with aspirin hypersensitivity.
哮喘患者炎症性疾病的治疗可能是个严重问题，因为一些患者对阿司匹林和其他非甾体类抗炎药（即环氧化酶抑制剂）不耐受。水杨酸盐曾被认为耐受性良好，但最近的报告表明，双氟尼酸和水杨酸水杨酸可在对阿司匹林不耐受的患者中引发哮喘发作。本研究旨在确定三水杨酸胆碱镁（CMT）的耐受性，CMT是一种具有强效镇痛和抗炎活性的非乙酰化水杨酸盐，研究对象为23名经口服激发试验确诊对阿司匹林过敏的哮喘患者。该研究包括三个阶段：1）患者在单盲方案下接受递增剂量（50 - 1500毫克）的CMT；2）患者在双盲、随机、交叉设计中接受安慰剂或CMT激发试验；3）患者接受每日3000毫克剂量的CMT，持续1周。在整个研究过程中，监测肺功能测试、鼻吸气峰值流量以及血清水杨酸盐和血栓素B2（TXB2）水平。结果显示，服用CMT后未出现气道阻塞、鼻充血或流涕。血清TXB2水平无显著下降，表明CMT未抑制环氧化酶。我们得出结论，对于对阿司匹林过敏的哮喘患者，三水杨酸胆碱镁是治疗不同炎症性疾病的安全药物。
