Prescribing pattern of COX-2 inhibitors in patients with a history of allergy to conventional NSAIDs in hospital belong to Thai Redcross Society

Abstract

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are known to cause allergic reactions, particularly conventional NSAIDs [1,2]. COX-2 inhibitors may be a suitable alternative for patients with a history of conventional NSAIDs allergies [3]. This study aimed to explore the prescribing rate and pattern of COX-2 inhibitors in patients with a history of conventional NSAIDs allergies. Method: A retrospective descriptive study was conducted using the computerized drug allergy history database from Queen Savang Vadhana Memorial Hospital (QSMH) between January 1, 2013, and December 31, 2016. Percentage statistics were used for comparison. Results: Among 638 patients, the most common allergy was to ibuprofen (34.95%), and the most frequently prescribed COX-2 inhibitor was etoricoxib (34.48%). The most common type of allergy to conventional NSAIDs was angioedema (42.65%), primarily associated with ibuprofen. Non-serious adverse drug reactions (ADRs) occurred in 90.61% of cases, while serious ADRs (anaphylaxis, acute renal failure, and anaphylactic shock) accounted for 9.39%. Physician staff prescribed COX-2 inhibitors most frequently (63.75%), with the orthopedic surgery unit being the most common prescribing department (48.17%). Etoricoxib was the most frequently prescribed COX-2 inhibitor (34.48%), particularly in cases where ibuprofen was the offending agent (34.95%). This highlights its critical role in managing NSAIDs allergies. Conclusion: This study provides insights into the prescribing pattern of COX-2 inhibitors in patients with a history of conventional NSAIDs allergies. This information is valuable for establishing monitoring plans to ensure optimal medication safety for this patient group.