Tolerability of meloxicam in patients with histories of adverse reactions to nonsteroidal anti-inflammatory drugs.

Abstract

BACKGROUND:

Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequent, particularly among patients with chronic urticaria or asthma. The need to identify an alternative drug that is safe and reliable is a common problem in clinical practice.

OBJECTIVE:

To assess the tolerability of meloxicam, a new NSAID that selectively inhibits the inducible isoform of cyclooxygenase, in a group of NSAID-sensitive patients.

PATIENTS AND METHODS:

We studied 177 patients who had suffered adverse reactions to one or more NSAIDs. Cutaneous reactions were reported by 83.1% of the subjects (urticaria in 55, angioedema in 52, urticaria/angioedema in 39, and maculopapular rash in 1), respiratory symptoms by 3.9%, both cutaneous and respiratory symptoms by 9%, Stevens-Johnson's syndrome by 2.3%, and anaphylactoid reactions by 1.7%. All subjects underwent a single-blind, placebo-controlled oral challenge with divided therapeutic doses of meloxicam (1.9 mg + 5.6 mg 1 hour later = cumulative dose 7.5 mg).

RESULTS:

Positive reactions were observed in only two cases (1.1%), both manifested exclusively by cutaneous symptoms (urticaria/angioedema in one case and maculopapular rash/facial edema in the second).

CONCLUSION:

Meloxicam seems to be well tolerated by NSAID-sensitive subjects whose reactions are manifested by urticaria/angioedema. Additional study is needed for a more complete assessment of its tolerability in patients with aspirin-induced asthma and other severe manifestations of NSAID sensitivity.

• Authors: D Quaratino, A Romano, M Di Fonso, G Papa, M R Perrone, F P D'Ambrosio, A Venuti
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 84 Issue 6 Pg. 613-7 (Jun 2000) ISSN: 1081-1206 [Print] United States
• PMID: 10875490 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Cyclooxygenase Inhibitors
• Thiazines
• Thiazoles
• Meloxicam

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anaphylaxis (chemically induced)
• Angioedema (chemically induced)
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Asthma (drug therapy)
• Chronic Disease
• Cyclooxygenase Inhibitors
• Drug Eruptions (etiology)
• Female
• Forced Expiratory Volume (drug effects)
• Humans
• Male
• Meloxicam
• Middle Aged
• Thiazines (adverse effects)
• Thiazoles (adverse effects)
• Urticaria (drug therapy)