AB0273 HYPERSENSIVITY REACTIONS TO NON STEROID ANTI INFLAMMATORY DRUGS: A BOUT 87 CASES

Background:

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs. The pathogenesis may be immunological mechanisms (allergic reactions) or non specific immunological reactions often incriminated in cross reactivity independently of chemical structure of these molecules. Understanding of the underlying mechanism is necessary for prevention and choice of safe alternatives [1, 2].

Objectives:

Analyze all cases of non-steroidal anti-inflammatory drugs cutaneous eruption reported to sfax pharmacovigilance service since January 2015 to December 2020 and evaluate the possibility of cross-reactions between different molecules in this class.

Methods:

We conducted a retrospective study of all cases reported to sfax pharmacovigilance department. An enquiry of pharmacovigilance was performed in patients who presented side effects to AINS. The imputability study was carried out by the French method of Imputability. Medical history specifies if there is a re-administration to assess tolerance and cross-reactivity.

Results:

Our study included 87 patients whose average age was 45, 8 years. The sex ratio (F/M) was 1.18. lysine salicylate acetyl is the most incriminated (31%), then mefenamic acid (19.5%), diclofenac (19.5 %), ketoprofen in (9.2%), piroxicam in (6.9 %), ibuprofen in (5.4%), celocoxib in (3.4%), tiaprofenic acid in (1.1%) and naproxen in 1.1% of cases. The most common skin injury was urticaria in 29 cases (33.3%). Fixed drug eruption was observed in 17 cases. Maculopapular rash was observed in 19 cases, anaphylaxis in 5 cases and 4 cases of photosensitivity were observed. In our study we found cross-reactivity between (NSAIDs) in 8 patients.

Conclusion:

The diagnostic approach is often based on the controlled administration of the drug to assess tolerance and to identify safe alternatives. In cases of intolerance to COX 1 inhibitors, cross-reactions to selective cox 2 inhibitors are very rare [3].

References:

[1]Inmaculada Dona, Maria Salas, James R Perkins and al. Hypersensitivity Reactions to Non-Steroidal Anti-Inflammatory Drugs. Curr Pharm Des 2016; 22(45):6784-6802.

[2]Flavia Angeletti, Franziska Meier, Nadja Zöller, Markus Meissner, Roland Kaufmann, Eva Maria Valesky. Hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) - a retrospective study. J Dtsch Dermatol Ges 2020 Dec; 18(12):1405-1414.

[3]N Blanca-López, J A Cornejo-García, M C Plaza-Serón, and al. Hypersensitivity to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Cross-Intolerance Reactions. J Investig Allergol Clin Immunol 2015; 25(4):259-69.

Disclosure of Interests:

None declared

AB0059 STUDY OF THE ANTI-INFLAMMATORY EFFECT OF CINNAMOMUM VERUM IN RATS

Background:

Inflammatory response is a common physiological response that protects the host of many harmful stimuli such as toxins, local injuries and pathogens. Today, non-steroidal anti-inflammatory drugs are the most commonly prescribed for the treatment of many inflammatory treatments. However, long term administration of these NSAIDs causes many adverse effects, including gastrointestinal ulcers and bleeding and kidney damage. Therefore, the need for new anti-inflammatory drugs with fewer side effects is required.

Objectives:

The aim of our study was to evaluate the anti-inflammatory activity of Cinnamomum verum (C. Verum) on rats while testing the dose effect and the typical effect of the solvent.

Methods:

The edema was induced by injection of carrageenan solution (CARR) in paw of rats according to the method of Winter et al, 1963. The measurements of volumes of right hind paw of each rat were taken before induction of edema and each 1 h, 2 h, 3 h, 4 h and 5 h after the injection of carrageenan. 7 groups of 6 rats received, one hour before the injection of the carrageenan, different treatment: G1= witness, G2=CARR + saline solution, G3= CARR+ Acetylsalicylic acid, G4= CARR + C. verum- MeOH 100, G5= CARR + C. verum- MeOH 300, G6= CARR + CARR + C. verum- EtOH 100 and G7= CARR + C.verum- EtOH 300.

Results:

For this test, the volume of edema increases with time, this increase is greater in the group treated with saline solution than with the extracts of C.Verum and with Acetylsalicylic acid. The extracts of C. Verum administered intraperitoneally one hour before the injection of the carrageenan, reduced the edema in the third hour after.

Conclusion:

The interesting anti-inflammatory activity of Cinnamomum verum recorded in this work may at least in part support its popular use in traditional medicine [1, 2].

References:

[1]Mirza Muhammad Fahd Qadir, Attya Bhatti, Muhammad Usman Ashraf, Mansur Abdullah Sandhu, Sidrah Anjum, Peter John. Immunomodulatory and therapeutic role of Cinnamomum verum extracts in collagen-induced arthritic BALB/c mice. Inflammopharmacology 2018 Feb;26(1):157-170.

[2]Heping Cao, Joseph F Urban Jr, Richard A Anderson. Cinnamon polyphenol extract affects immune responses by regulating anti- and proinflammatory and glucose transporter gene expression in mouse macrophages. J Nutr 2008 May;138(5):833-40.

Disclosure of Interests:

None declared