{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:38:28Z","timestamp":1792640308791,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2011,8,11]],"date-time":"2011-08-11T00:00:00Z","timestamp":1313020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:sec><jats:label\/><jats:p><jats:bold>To cite this article:<\/jats:bold> Do\u00f1a I, Blanca\u2010L\u00f3pez N, Jagemann LR, Torres MJ, Rond\u00f3n C, Campo P, G\u00f3mez AI, Fern\u00e1ndez J, Laguna JJ, Rosado A, Blanca M, Canto G. Response to a selective COX\u20102 inhibitor in patients with urticaria\/angioedema induced by nonsteroidal anti\u2010inflammatory drugs. <jats:italic>Allergy<\/jats:italic> 2011; <jats:bold>66<\/jats:bold>: 1428\u20131433.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background:\u2002<\/jats:bold> In subjects with hypersensitivity reactions with cross\u2010intolerance to nonsteroidal anti\u2010inflammatory drugs (NSAIDs), tolerance to selective COX\u20102 inhibitors has not been evaluated in large series of well\u2010phenotyped cases.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> We evaluated 252 patients with urticaria and\/or angioedema caused by hypersensitivity owing to cross\u2010intolerance to NSAIDs. In addition to the clinical history, diagnosis was confirmed by provocation to an alternative NSAID. Two groups were considered: (A) patients with cross\u2010intolerance to NSAIDs and intolerance to paracetamol and (B) patients with cross\u2010intolerance to NSAIDs and good tolerance to paracetamol. Etoricoxib was administered to Group\u2003A patients and to a representative sample of Group\u2003B patients. In the event of a positive response, serum tryptase levels were determined and skin biopsy was performed in five patients in each group.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Ibuprofen was the most commonly implicated drug, followed by acetylsalicylic acid (ASA). Urticaria was the most common manifestation, followed by angioedema. Most of the patients developed symptoms within 1\u2003h. Twenty\u2010five percent in Group\u2003A (<jats:italic>n<\/jats:italic>\u2003=\u200347) and 6% in Group\u2003B (<jats:italic>n<\/jats:italic>\u2003=\u200350) were intolerant to etoricoxib. Skin biopsy showed mast cell activation with the release of tryptase to the extracellular space but without the increase in serum tryptase levels.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Selective COX\u20102 inhibitors may be unsafe in subjects with urticaria and\/or angioedema caused by hypersensitivity reactions to NSAIDs with cross\u2010intolerance if they are intolerant to paracetamol. A quarter of patients who were intolerant to this drug were also intolerant to etoricoxib. In subjects with hypersensitivity to NSAIDs and intolerance to paracetamol, selective COX\u20102 inhibitors should be administered as a controlled, incremental dose provocation test to assess tolerance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1398-9995.2011.02684.x","type":"journal-article","created":{"date-parts":[[2011,8,11]],"date-time":"2011-08-11T13:26:33Z","timestamp":1313069193000},"page":"1428-1433","source":"Crossref","is-referenced-by-count":53,"title":["Response to a selective COX\u20102 inhibitor in patients with urticaria\/angioedema induced by nonsteroidal anti\u2010inflammatory drugs"],"prefix":"10.1111","volume":"66","author":[{"given":"I.","family":"Do\u00f1a","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Blanca\u2010L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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