COX-2 Inhibitors Are Safe in Patients with Aspirin-Exacerbated Respiratory Disease

The triad of asthma, aspirin sensitivity, and nasal polyposis is known as aspirin-exacerbated respiratory disease (AERD). AERD is caused by inhibition of the cyclooxygenase (COX)-1 enzyme, which, in susceptible patients, causes high cysteinyl leukotriene levels and resulting asthma and rhinitis symptoms. All nonsteroidal anti-inflammatory drugs (NSAIDs) carry an FDA contraindication for patients with AERD, but such patients usually tolerate COX-2 inhibitors.

To examine the safety of COX-2 inhibitors (i.e., celecoxib and rofecoxib) or traditional NSAIDs with relatively high COX-2 selectivity (e.g., meloxicam) in AERD patients, researchers analyzed 14 blinded, placebo-controlled trials (426 patients). No patient who received COX-2 inhibitors r…