Long-term tolerability of etoricoxib in different types of NSAID-intolerant subjects

M. Pagani, P. Bonadonna, A. Dama, G.E. Senna, P.P. Vescovi, A. Antico

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are a frequent cause of hypersensitivity reactions, therefore, in clinical practice, it's important to find safe and effective substances. Objective: To evaluate the tolerability of etoricoxib and its subsequent actual use and safety at home. Methods: Etoricoxib tolerance was assessed by single-blindplacebo- controlled oral challenges and its subsequent use was checked by a standardized telephone call. The test was performed in 139 subjects (83 single NSAID reactors and 56 multiple NSAID reactors). Results: The drug was not tolerated in 4 cases (2,8%) causing wheals on the face area in 3 single reactors and a severe generalised reaction occurring three hours after the intake of a therapeutic dose in a multiple reactor. The phone calls showed that 64 (52,8%) patients did not take etoricoxib, mostly due to the fear of adverse effects; in 5 cases (4,2%), the practitioner prescribed a different NSAIDs. Only 52 (43%) subjects took etoricoxib after oral challenges; all tolerated the drug but 2 single reactors, who reported a very mild labial oedema. Conclusion: Our study confirmed the good long-term tolerability of etoricoxib in patients with a history of hypersensitivity to other NSAIDs without differences between single and multiple reactors. Nonetheless, in NSAID-intolerant subjects this drug should be first challenged in specialised centres due to the risk of severe reactions.
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