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LETTERS: Enrique J Sánchez-Delgado Life without COX 2 inhibitors: Risks and benefits are determined by dose and potency BMJ 2006; 332: 1451-b-1452-b [Full text]

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COX II inhibitors have a unique indication.

Marise A McQueen   (20 June 2006)

COX II inhibitors have a unique indication. 20 June 2006
Marise A McQueen, Clinical Assistant at West of Scotland Anaphylaxis Service. Western Infirmary, Glasgow G11 6NT Send response to journal: Re: COX II inhibitors have a unique indication.	I have followed the various articles, reports and correspondence in the BMJ on this subject. I am very surprised that none of the contributors have mentioned the place of COX II inhibitors in the substantial minority of the population who are intollerant of Aspirin and traditional COX II inhibitor NSAIDs. In our clinic we see these patients frequently. The reaction to NSAIDs is anything from an exacerbation of urticaria (30% of CIU), angioedema, wheeze, through to full anaphylactoid reactions and cardiac arrest. The above group of patients are often tollerant of COX II inhibitors and their use for analgesic and anti-inflammatory purposes is extremely usefull. At our clinic we offer an oral challenge to celecoxib in these patients. Yours faithfully, Marise McQueen, MB ChB, MRCGP, FFARCS. Competing interests: None declared