COX 2 inhibitors are the medication of choice in patients with ASA sensitivity. I don’t recall any incident of reaction to COX 2 inhibitors in patients with aspirin sensitivity. But a report of a patient who reacted to COX 2 inhibitor happened to be on low dose 100 mg aspirin prophylaxis for anti-platelet effect for a long time and theoretically it is possible that chronic exposure may cause low PGE2 and result in such a reaction. That literature keeps us all at the edge of our seats during desensitization of these select patients.