Etoricoxib, common pain killer linked to oral adverse drug reactions: JADA

Etoricoxib, common pain killer linked to oral adverse drug reactions (ADR), revealed a study published in the Journal of American Dental Association (JADA).

Etoricoxib is a highly selective COX-2 inhibitor which is used increasingly in clinical practice mainly for the treatment of osteoarthritis and rheumatoid arthritis and for pain control. There have been reports of cutaneous adverse reactions to etoricoxib. In this report, the authors describe the first series of patients with adverse reactions to etoricoxib restricted to oral mucosa.

In this study, cases with specific oral ADR associated with etoricoxib were collected from 5 medical centers with oral medicine services. The authors collected data that included demographics, general health status, and regular medications at the time of etoricoxib intake; clinical information regarding the oral location of the lesions and type (for example, erosions, ulcers, and vesicles); presence of cutaneous lesions; need for treatment and agents used; and clinical outcome in terms of time to resolution.

Following are the key observations noted by the authors

• The series comprised 7 men and 4 women, aged 25 through 81 years, 10 of whom had only oral lesions, 1 with mucocutaneous involvement.


• Lesions were erosive and aphthous-like or erythema multiform-like.


• In most of the cases, bilateral involvement of the palate was reported.


• Lips, tongue, and buccal mucosa were also involved.


• All lesions resolved after drug discontinuation.


• In 6 patients, repeated use resulted in recurrence of signs and symptoms similar to the first attack.

The authors concluded that this first reported case series indicates the importance of specific targeted questions regarding the use of etoricoxib that should be asked by the physician faced with oral and specifically palatal erosions. The cases in this series seem to suggest a type B reaction, owing to the clinical presentation of rapid onset, primarily oral or mucocutaneous reaction, and the characteristic erosive lesions that are typical for other immune-mediated oral mucosal lesions, the authors wrote.

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https://doi.org/10.1016/j.adaj.2019.01.028