Aspirin desensitization in patients with AERD
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All patients with aspirin exacerbated respiratory disease (AERD) can be desensitized to ASA. After achieving this state, patients can then take ASA daily without adverse effect. ASA desensitization can be maintained indefinitely as long as the patient takes ASA each day. Crossdesensitization with older NSAIDs also occurs. After ASA desensitization, patients can take daily ASA in order to treat their underlying respiratory disease. In AERD patients treated with ASA 650 BID for at least a year, 115/172 (67%) improved in their clinical courses while decreasing systemic and topical corticosteroids. Sixteen failed to improve, 24 stopped ASA because of intractable side effects (gastritis or hives) and 17 patients discontinued ASA treatment in the first year of study for unrelated reasons. Therefore, treatment with daily ASA is a significant therapeutic option for patients afflicted with AERD. It should be used for AERD patients who do not respond to topical corticosteroids and leukotriene modifier drugs. Those who respond to systemic steroids or have intractable or recurrent nasal polyps are particularly well-suited for this therapeutic intervention.
Index EntriesAspirin (ASA) nonsteroidal antiinflammatory drug (NSAID) aspirin-exacerbated respiratory disease (AERD) general clinical research center (GCRC)
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- 2.Stevenson, D., and Simon, R. A. Sensitivity to aspirin and nonsteroidal antiinflammatory drugs, in Allergy: Principles and Practice. Middleton, Jr., E., Ellis, E. F., Yunginger, J. W., Reed, C. E., Adkinson, N. F., Jr., and Busse, W. W., eds., vol. 2, 5th ed. Mosby, St. Louis, 1998, pp. 1225–1234.Google Scholar
- 4.Bianco, S. R. M., and Petrini, G. (1977), Aspirin induced tolerance in aspirin-asthma detected by a new challenge test. IRCS J. Med. Sci. 5, 129–136.Google Scholar
- 6.Pleskow, W. W., Stevenson, D. D., Mathison, D. A., Simon, R. A., Schatz, M., and Zieger, R. S. (1982), Aspirin desensitization in aspirin sensitive asthmatic patients: clinical and manifestations and characterization of the refractory period. J. Allergy Clin. Immunol. 69, 11–19.PubMedCrossRefGoogle Scholar
- 7.Stevenson, D. (1999), Oral desensitization to aspirin. AIANE 1–4.Google Scholar
- 8.Stevenson, D. D. Drug-induced asthma, in Asthma, Slavin, R. and Reisman, R. E., eds., vol. 1. American College of Physicians, Philadelphia, 2002, pp. 191–208.Google Scholar
- 17.Berges-Gimeno, M. P., Simon, R. A., and Stevenson, D. D. (2003) Treatment with aspirin desensitization in aspirin exacerbated respiratory disease. J. Allergy Clin. Immunol. (Accepted for publication.)Google Scholar