Regular Treatment With Aspirin 300 mg/day After Desensitization in Patients With N-ERD: 12-Year Results.

OBJECTIVE Aspirin desensitization is recommended for patients with nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity, in whom asthma is uncontrolled despite medical treatment, and/or frequent endoscopic sinus surgery (ESS) is required due to nasal polyps. There are few studies in the literature on long-term follow-up of patients undergoing regular aspirin treatment after desensitization. This study aims to evaluate the effect of regular aspirin treatment on respiratory function, symptom control, quality of life, and the number of nasal surgeries required during a period of 12 years. MATERIAL AND METHODS A total of 18 patients were included in the study in 2006; 11 patients were excluded and 7 patients regularly taking aspirin for 12 years were evaluated. Oral aspirin desensitization was performed at 4-6 weeks following the ESS. Patients receiving 300 mg/day aspirin were followed up in control visits every 3 months. Nasal and respiratory system examinations and pulmonary function test were performed, and all patients responded to the SF-36 Quality of Life scale during each visit. RESULTS There was no change in respiratory function parameters following the12-year aspirin treatment. There was no statistically significant improvement in the quality of life; however, the need for ESS due to the recurrence of nasal polyps decreased significantly (P = .000). At the 12-year follow-up, all symptom scores improved, but improvement in the postnasal drip score was statistically significant (P = .046). CONCLUSION Long-term regular treatment with aspirin at a dose of 300 mg/day in patients with N-ERD improved symptom scores, and alleviated the need for ESS due to nasal polyp recurrence.

[1]  M. Tabor,et al.  Systematic review of outcomes for endoscopic sinus surgery and subsequent aspirin desensitization in aspirin-exacerbated respiratory disease , 2020, World journal of otorhinolaryngology - head and neck surgery.

[2]  Hae‐Sim Park,et al.  NSAID-Exacerbated Respiratory Disease (NERD): From Pathogenesis to Improved Care , 2020, Frontiers in Pharmacology.

[3]  Andrew A. White,et al.  Diagnosis and management of NSAID‐Exacerbated Respiratory Disease (N‐ERD)—a EAACI position paper , 2018, Allergy.

[4]  Andrew A. White,et al.  Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease , 2018, American journal of rhinology & allergy.

[5]  J. Palmer,et al.  Outcomes after complete endoscopic sinus surgery and aspirin desensitization in aspirin‐exacerbated respiratory disease , 2018, International forum of allergy & rhinology.

[6]  M. Kowalski,et al.  Clinical Trials of Aspirin Treatment After Desensitization in Aspirin-Exacerbated Respiratory Disease. , 2016, Immunology and allergy clinics of North America.

[7]  B. Rotenberg,et al.  A retrospective study of the clinical benefit from acetylsalicylic acid desensitization in patients with nasal polyposis and asthma , 2014, Allergy, Asthma & Clinical Immunology.

[8]  K. Nadeau,et al.  Long-term Sinonasal Outcomes of Aspirin Desensitization in Aspirin Exacerbated Respiratory Disease , 2014, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[9]  G. Karakaya,et al.  Aspirin 300 mg/day is effective for treating aspirin‐exacerbated respiratory disease , 2013, Allergy.

[10]  G. Karakaya,et al.  Non-steroidal anti-inflammatory drug hypersensitivity in adults and the factors associated with asthma. , 2013, Respiratory medicine.

[11]  S. Holgate,et al.  Aspirin Exacerbated Respiratory Disease , 2012, Journal of allergy.

[12]  L. Teran,et al.  Rhinosinusitis and Aspirin-Exacerbated Respiratory Disease , 2012, Journal of allergy.

[13]  G. O'Connor,et al.  Rate Of FEV1 Decline In Healthy Adults: Defining The Upper Limit Of Normal In The Framingham Heart Study , 2012, ATS 2012.

[14]  T. Deutschle,et al.  Long‐term treatment with aspirin desensitization: a prospective clinical trial comparing 100 and 300 mg aspirin daily , 2008, Allergy.

[15]  J. Cohn Aspirin challenge and desensitization for aspirin-exacerbated respiratory disease: a practice paper. , 2007, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[16]  C. Jenkins,et al.  Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice , 2004, BMJ : British Medical Journal.

[17]  W. Mann,et al.  Individual monitoring of aspirin desensitization. , 2001, Archives of otolaryngology--head & neck surgery.

[18]  Y. Bariş,et al.  Occurrence of allergic conditions in asthmatics with analgesic intolerance , 1999, Allergy.

[19]  Andrew A. White,et al.  Evidence-based approach to aspirin desensitization in aspirin-exacerbated respiratory disease. , 2014, The Journal of allergy and clinical immunology.

[20]  R. Simon,et al.  Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory disease. , 2007, The Journal of allergy and clinical immunology.

[21]  R. Simon,et al.  Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. , 2003, The Journal of allergy and clinical immunology.