As reported in CHEST (June 2002), several studies1–4
have suggested that selective cyclooxygenase-2 (COX-2) inhibitors, rofecoxib and celecoxib, are safe for use by patients with aspirin-induced asthma and who are intolerant to cyclooxygenase-1 (COX-1) inhibitors. However, there are less than 140 patients in all four of these studies. We wish to report a 78-year-old woman with asthma, well-controlled with beclomethasone and albuterol inhalers for at least 3 years, who developed an acute exacerbation of asthma symptoms after three doses of rofecoxib, each 25 mg. This patient had previously had an adverse reaction to aspirin and since then had avoided aspirin and all nonsteroidal antiinflammatory medications, using only acetaminophen for pain relief. The rofecoxib was stopped, and she responded to nebulized albuterol and prednisone therapy, and her symptoms improved.