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Efficacy and Tolerability of Nimesulide in Asthmatic Patients Intolerant to Aspirin

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Summary

Inflammation of the airways accompanied by eosinophil infiltration appears to play a fundamental role in the pathogenesis of bronchial asthma. Therefore, anti-inflammatory agents (at present corticosteroids, cromoglycate and nedocromil) are the first-line treatment for this condition. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (acetylsalicylic acid) and indomethacin, however, have never been used in this setting, mainly for fear of adverse effects (e.g. severe obstructive reactions); these can occur, in a consistent number of patients as a consequence (according to the most widely accepted theory) of inhibition of prostaglandin synthesis. In a double-blind crossover placebo-controlled study involving 20 aspirin-sensitive patients with asthma, we found that oral nimesulide 100mg was well tolerated both clinically and functionally (no significant changes in forced expiratory volume in 1 second and specific airway resistance after drug intake). In a more recent study, we observed a mild obstructive reaction (easily controlled with inhaled bronchodilators) after oral administration of nimesulide 400mg to 3 patients who had previously tolerated a 100mg dose. On the basis of clinical experience, nimesulide (unlike most other NSAIDs) in the recommended doses appears to be well tolerated in aspirin-sensitive asthmatic patients. Furthermore, this distinctive anti-inflammatory agent might provide a novel approach to the treatment of bronchial asthma.

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Authors and Affiliations

  1. Institute of Cardiovascular and Respiratory Diseases, University of Milan, Via W. Tobagi 17, 20143, Milan, Italy

    S. Bianco

  2. Institute of Respiratory Diseases, University of Milan, Milan, Italy

    M. Robuschi, G. Petrigni & M. Scuri

  3. Institute of Respiratory Diseases, University of Siena, Siena, Italy

    M. G. Pieroni, R. M. Refini & P. S. Sestini

  4. Pneumological Division, Hospital of Garbagnate, Garbagnate, Italy

    A. Vaghi

Authors
  1. S. Bianco
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  2. M. Robuschi
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  3. G. Petrigni
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  4. M. Scuri
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  5. M. G. Pieroni
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  6. R. M. Refini
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  7. A. Vaghi
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  8. P. S. Sestini
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Bianco, S., Robuschi, M., Petrigni, G. et al. Efficacy and Tolerability of Nimesulide in Asthmatic Patients Intolerant to Aspirin. Drugs 46 (Suppl 1), 115–120 (1993). https://doi.org/10.2165/00003495-199300461-00024

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  • DOI: https://doi.org/10.2165/00003495-199300461-00024

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