Factor-Associated in Pattern of Non-Steroidal Anti-
Inflammatory Drug-Induced Cutaneous Adverse Drug
Reactions in the Elderly
Papapit Tuchinda MD 1 , Leena Chularojanamontri MD 1 , Pattriya Chanyachailert MD 1 , Kanokvalai Kulthanan MD 1 ,
Kowit Jongjarearnprasert MS 2 , Panadda Uthaitas B.Pharm 2
Affiliation : 1 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Department of Pharmacy, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medications in elderly,
which can frequently cause cutaneous adverse drug reactions (ADRs).
Objective : The present study aimed to investigate demographic data of elderly patients who had cutaneous reactions from NSAIDs and determine the risk factors that induce serious reactions.
Materials and Methods : A retrospective analysis involving elderly patients aged 60 years or over with cutaneous ADRs suspected from NSAIDs attending the ADR Center, Siriraj Hospital, Mahidol University, Thailand, over a 4-year period. Demographic data, concurrent medications, clinical course of cutaneous ADRs and causative NSAIDs were analyzed.
Results : A total of 101 patients were included. Cutaneous ADRs from NSAIDs occurred more commonly in females (65.3%). Angioedema alone was the most common cutaneous ADRs (29.7%) followed by urticaria with and without angioedema (26.7%). Forty-one patients (40.6%) were categorized as serious ADRs. Systemic reactions were significantly associated with non-selective COX inhibitors as compared to preferential and selective COX-2 inhibitors ( p = 0.046). A history of severe cutaneous ADRs is significantly associated with severity of cutaneous ADRs to NSAIDs in elderly (p<0.001).
Conclusion : Preferential and selective COX-2 inhibitors may be a good option for elderly due to lower risk of cutaneous ADRs. Early signs and symptoms of severe reactions should be addressed in this group of patients.
Keywords : cutaneous, adverse reaction, NSAID, elderly, geriatric
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