Selektive Cyclooxygenase-II-Hemmer bei Patienten mit pseudoallergischen Reaktionen auf nichtsteroidale Antiphlogistika

Zusammenfassung

Pseudoallergische Reaktionen auf nichtsteriodale Antiphlogistika sind mit einer geschätzten Inzidenz von 2 % häufig zu beobachtende Nebenwirkungen bei der Behandlung von chronischen Schmerzzuständen und nicht-infektiösen Entzündungen. Sie können in ihrer schwersten Form anaphylaktoide Schockreaktionen auslösen. Patienten mit diesem Krankheitsbild befinden sich daher häufig in der allergologischen Abklärung. In diesem Artikel werden aktuelle Modelle zur Pathogenese und Möglichkeiten der Diagnostik besprochen. Besonders gehen wir auf die Verwendung neuer Schmerzmittel mit spezifischer Hemmung der Cyclooxigenase II ein, da diese Präparate offenbar eine gute Verträglichkeit bei Patienten mit pseudoallergischen Reaktionen aufweisen.

Abstract

Pseudoallergic reactions to non-steroidal anti-inflammatory drugs (NSAID) are frequently occurring side-effects during the treatment of chronic pain conditions and non-infectious inflammation. The incidence is estimated to be 2 %. In severe cases anaphylactoid reactions may develop. Patients suffering from this disease are therefore frequently transferred to allergologic units for diagnosis. Here, we review current insights into the pathomechanisms and treatment modalities of NSAID-intolerance. Especially, we address the use of new anti-inflammatory drugs with selective inhibition of the Cyclooxigenase II, since these drugs may have a lower risk of pseudo-allergic reactions in patients with NSAID-intolerance.

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