Original Paper

Safety of Meloxicam in Aspirin-Hypersensitive Patients with Asthma and/or Nasal Polyps
A Challenge-Proven Study
Sevim Bavbek^a, A. Berna Dursun^a, Engin Dursun^b, Adil Erylmaz^b, Zeynep Msrlgil<sup>a

a</sup>Department of Allergic Diseases, Ankara University School of Medicine, and
^bThird Ear, Nose and Throat Clinic, Ankara Numune Training and Research Hospital, Ministry of Health, Ankara, Turkey

Address of Corresponding Author

Int Arch Allergy Immunol 2007;142:64-69 (DOI: 10.1159/000096000)

  Key Words

• Aspirin hypersensitivity
• Aspirin provocation test
• Asthma
• Meloxicam
• Nasal polyposis

  Abstract

Background: The anti-inflammatory actions of acetylsalicylic acid (ASA)/non-steroidal anti-inflammatory drugs (NSAIDs) are thought to be due to inhibition of COX-2, whereas the side effects such as gastric damage and aspirin-induced asthma are mediated through inhibition of COX-1. Therefore, a new class of drugs with COX-2 selectivity may be well tolerated by patients with ASA/NSAIDs hypersensitivity. Objective: We investigated whether subjects with asthma and/or nasal polyps (NP) and analgesic intolerance proven by oral ASA provocation test tolerated the selective COX-2 inhibitor, meloxicam. Methods: All subjects were first challenged with ASA using a 2-day, single-blind, placebo-controlled oral provocation test. Thereafter, the subjects showing positive response to ASA provocation underwent a single-blind, placebo-controlled challenge with a cumulative dose of 7.5 mg of meloxicam on 2 separate days. One and three fourths of the divided doses of placebo and the active drug were given at 1-hour intervals. Clinical symptoms, lung function, and blood pressure were monitored during these challenge protocols. Results: Twenty-one patients with asthma and/or NP (10 males and 11 females; mean age: 38.4 ± 2.9 years) who reacted to ASA challenges were enrolled in the study. Response to ASA provocation was rhinitis + bronchospasm in 13, and extrabronchial reactions in 8 (isolated rhinitis in 3) patients. Mean PD₂₀ was 163.4 ± 39.9 mg ASA among patients who reacted with bronchospasm to ASA. Only 1 patient reacted to meloxicam challenge at a cumulative dose of 7.5 mg. Conclusion: This study indicates that 7.5 mg of meloxicam is a safe alternative treatment for ASA-hypersensitive asthma and/or NP patients with proven hypersensitivity via oral ASA challenges.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Correspondence to: Prof. Sevim Bavbek
Angora Evleri, Bulumalar cad. C1-2A
Beysukent-Ankara (Turkey)
Tel. +90 312 352 3920, Fax +90 312 319 0046
E-Mail bavbek@medicine.ankara.edu.tr

  Article Information

Received: December 19, 2005
Accepted after revision: April 20, 2006
Published online: October 2, 2006
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 34