A retrospective study of the clinical benefit from acetylsalicylic acid desensitization in patients with nasal polyposis and asthma

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• 作者：Christine Ibrahim ; Kulraj Singh ; Gina Tsai…
• 关键词：Aspirin desensitization ; Nasal polyposis ; Rhinosinusitis ; Asthma ; Aspirin ; exacerbated respiratory disease
• 刊名：Allergy, Asthma & Clinical Immunology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：10
• 期：1
• 全文大小：198 KB
• 参考文献：1. Widal, MF (1922) Anaphylaxie et idiosyncraise. Press Med 119: pp. 48-51
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  14. Swierczynska-Krepa, M, Sanak, M, Bochenek, G, Strek, P, Cmiel, A, Gielicz, A, Plutecka, H, Szczeklik, A, Nizankowska-Mogilnicka, E (2014) Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: a double blind study. J Allergy Clin Immunol 134: pp. 883-890 CrossRef
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  16. Cho, KS, Soudry, E, Psaltis, AJ, Nadeau, KC, McGhee, SA, Nayak, JV, Hwang, PH (2014) Long-term sinonasal outcomes of aspirin desensitization in aspirin exacerbated respiratory disease. Otolar
• 刊物主题：Allergology; Immunology; Pneumology/Respiratory System;
• 出版者：BioMed Central
• ISSN：1710-1492

文摘

Background Aspirin-exacerbated respiratory disease (AERD), also known as Samter’s triad, is a clinical syndrome which consists of aspirin (ASA) intolerance, chronic rhinosinusitis with nasal polyposis, and intrinsic bronchial asthma (Press Med 119:48-51, 1922). ASA challenge is the gold standard for diagnosing AERD (Curr Allergy Asthma 9:155-163, 2009). The practice of ASA challenge and desensitization in Canada is infrequently utilized, which may explain its omission as a viable therapeutic option in the latest Canadian clinical practice guidelines for acute and chronic rhinosinusitis (AACI 7:1-38, 2011). Methods This retrospective study assessed 111 patients who underwent ASA desensitization in the Allergy and Immunology clinic at St. Joseph’s Healthcare (SJHC) in London, Ontario. The mean age was 50.7?years, and 52.5% (n--8) were male. Sixty-one percent (n--8) claimed prior, significant reactions to ASA, and all patients had features of AERD. Results Seventy-three percent (n--1) claimed symptom improvement after achieving maintenance dosing on the desensitization protocol. Of this population, 21.6% (n--4) improved in all 3 areas of interest (sense of taste or smell, upper respiratory symptoms and lower respiratory symptoms). Twenty-six percent (n--9) had adverse effects, mostly in the way of gastrointestinal upset, but no severe adverse events were seen. Conclusions ASA desensitization helps improve symptoms in patients with AERD. Further, it allows patients to tolerate additional ASA and other non-steroidal anti-inflammatories (NSAIDs) when needed for supplemental analgesia or for cardio-protection. This is of particular benefit in those who require these medications for improved quality of life, and for reduced morbidity and mortality, such as those with cardiovascular disease or chronic pain. There should be further studies conducted in Canada as well as consideration for ASA desensitization to be included in the next clinical practice guidelines.