Exhaled nitric oxide variations during oral challenge with different NSAIDs in patients with aspirin-induced asthma

Abstract

Background: Patients with aspirin induced asthma (AIA) experience varying degrees of adverse respiratory reactions after use of nonsteroidal anti-inflammatory drugs (NSAIDs). The effect of oral challenges with different NSAIDs on fractional exhaled nitric oxide(FeNO) as a marker of airway inflammation has notbeen thoroughly investigated. Objectives: To investigate the effect of oral challenges with 3 different NSAIDs, namely Aspirin (ASA), nimesulide (NIM) and celecoxib(CEL) on FeNO values in patients with AIA. Methods: Oral challenge with all 3 drugs was performed in 30 patients with AIA and 15 patients with Aspirin Tolerant Asthma (ATA), compared with 15 normal subjects. Results: Patients with AIA and ATA had baseline FeNO significantly higher than controls (26.06 ± 7.74 and 23.74 ± 3.27 vs . 9.55 ± 2.00 p.p.b. respectively, p Conclusion: FeNO seems to be a sensitive and early marker of inflammation in patients with AIA receiving NSAIDs. The safety of COX-2 inhibitors seems to be further supported by the minimal increase in FeNO.