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Adaptive Desaktivierung bei Analgetikaintoleranz

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Allergologie

Zusammenfassung

Die adaptive Desaktivierung (AD) bei Analgetikaintoleranz ist ein Therapiekonzept, bei welchem durch die langfristige, tägliche Gabe von NSAID, wie bspw. Aspirin, eine Verbesserung des klinischen Verlaufs der Erkrankung erreicht werden kann. Hierbei schließt sich an eine initiale Einleitungsphase mit ansteigenden Dosen von Aspirin eine langjährige Erhaltungsphase mit einer kontinuierlichen Dosierung an. Verschiedene Protokolle für die Durchführung der Einleitungsphase sind publiziert. Auch die Empfehlungen zur optimalen Aspirindosis für die (tägliche) Erhaltungstherapie sind im nationalen und internationalen Vergleich sehr verschieden. Dies unterstreicht die Bedeutung der Durchführung von weiterführenden doppelblind, placebokontrollierten Dosisfindungsstudien zur AD.

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Literatur

  • Baenkler HW (2008) Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Ärztebl Int 105: 137–142

    Google Scholar 

  • Baker TW, Quinn JM (2011) Aspirin therapy in aspirin-exacerbated respiratory disease: a risk-benefit analysis for the practicing allergist. Allergy Asthma Proc 32: 335–340

    Google Scholar 

  • Berges-Gimeno MP, Simon RA, Stevenson DD (2003) Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 111: 180–186

    Google Scholar 

  • Dollner R, Hörmann K, Stuck BA, Pfaar O, Klimek L (2014) In-vitro-Diagnostik des ASS-Intoleranz-Syndroms (Aspirin-exacerbated Respiratory Disease: AERD). Allergologie 37: 11–19

    Google Scholar 

  • Dollner R, Klimek L, Pfaar O, Stuck BA, Hörmann K (2007) ln-vitro-Testverfahren bei Analgetikaintoleranz. Allergologie 30: 240–248

    Google Scholar 

  • Förster U, Olze H (2008) Analgetika-Intoleranz: Schlüsselposition von HNO-Ärzten bei der Früherkennung des Krankheitsbildes. HNO 56: 443–450; quiz 51

    Google Scholar 

  • Förster U, Strathmann S, Schafer D, Szczepek AJ, Olze H (2013) Eicosanoid imbalance correlates in vitro with the pattern of clinical symptoms of Samter’s triad. Rhinology 51: 61–69

    Google Scholar 

  • Fruth K, Pogorzelski B, Schmidtmann I, Springer J, Fennan N, Fraessdorf N, Boessert A, Schaefer D, Gosepath J, Mann WJ (2013) Low-dose aspirin desensitization in individuals with aspirin-exacerbated respiratory disease. Allergy 68(5): 659–665

    Google Scholar 

  • Gosepath J, Pfaar O (2013) Chronic Rhinosinusitis with and without Nasal Polyps. In: Georgalas C, Fokkens F (Hrsg) Rhinology and Skull Base Surgery. Thieme, Stuttgart, S 276–282

    Google Scholar 

  • Gosepath J, Schaefer D, Amedee RG, Mann WJ (2001) Individual monitoring of aspirin desensitization. Arch Otolaryngol Head Neck Surg 127: 316–321

    Google Scholar 

  • Gosepath J, Schäfer D, Mann WJ (2002) Analgetika-Intoleranz: Langzeitergebnisse bis zu 3 Jahren bei adaptiver Desaktivierung mit einer täglichen Erhaltungsdosis von 100 mg Aspirin. Laryngo-Rhino-Otol 81: 732–738

    Google Scholar 

  • Hedman J, Kaprio J, Poussa T, Nieminen MM (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28: 717–722

    Google Scholar 

  • Jacobs RL, Freedman PM, Boswell RN (1981) Nonallergic rhinitis with eosinophilia (NARES syndrome). Clinical and immunologic presentation. J Allergy Clin Immunol 67: 253–262

    Google Scholar 

  • Kirsche HP, Pfaar O, Olze H, Förster U (2013) Analgetikaintoleranz. Allergo J 22: 33–42

    Google Scholar 

  • Klimek L, Pfaar O (2009) Aspirin intolerance: does desensitization alter the course of the disease? Immunol Allergy Clin North Am 29: 669–675

    Google Scholar 

  • Klimek L, Pfaar O, Kirsche H (2014a) Die adaptive Desaktivierungsbehandlung bei Patienten mit ASS-Intoleranz-Syndrom: Übersicht über ein ursächlich-orientiertes Therapieprinzip. Allergologie 37: 26–33

    Google Scholar 

  • Klimek L, Dollner R, Pfaar O, Mullol J (2014b) Aspirin desensitization: useful treatment for chronic rhinosinusitis with nasal polyps (CRSwNP) in aspirin-exacerbated respiratory disease (AERD)? Curr Allergy Asthma Rep 14(6): 441

    Google Scholar 

  • Kowalski ML, Ptasinska A, Jedrzeiczak M, Bienkiewicz B, Cieslak M, Grzegorczyk J, Pawliczak R, Dubuske L (2005) Aspirin-triggered 15-HETE generation in peripheral blood leukocytes is a specific and sensitive Aspirin-Sensitive Patients Identification Test (ASPITest). Allergy 60: 1139–1145

    Google Scholar 

  • Lee RU, Stevenson DD (2011) Aspirin-exacerbated respiratory disease: evaluation and management. Allergy Asthma Immunol Res 3: 3–10

    Google Scholar 

  • Lee JY, Simon RA, Stevenson DD (2007) Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 119: 157–164

    Google Scholar 

  • Mendelsohn D, Jeremic G, Wright ED, Rotenberg BW (2011) Revision rates after endoscopic sinus surgery: a recurrence analysis. Ann Otol Rhinol Laryngol 120: 162–166

    Google Scholar 

  • Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczynska M, Picado C, Scadding G et al. (2007) EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy 62: 1111–1118

    Google Scholar 

  • Pfaar O, Klimek L (2006a) Aspirin desensitization in aspirin intolerance: update on current standards and recent improvements. Curr Opin Allergy Clin Immunol 6: 161–166

    Google Scholar 

  • Pfaar O, Klimek L (2006b) Eicosanoids, aspirin-intolerance and the upper airways--current standards and recent improvements of the desensitization therapy. J Physiol Pharmacol 57 (Suppl 12): 5–13

    Google Scholar 

  • Pfaar O, Spielhaupter M, Klimek L (2005) Max Samter – ein Pionier und Wegbereiter der modernen Allergologie und Rhinologie. Allergo J: 630–634

    Google Scholar 

  • Pfaar O, Spielhaupter M, Wrede H, Barth C, Schäfer D, Stuck BA, Mösges R, Hanschmann H, Hacksteden K, Hörmann K, Klimek L (2006) Adaptive Desaktivierung bei ASS-intoleranten Patienten mit Polyposis nasi et sinuum – Möglichkeiten eines neuen Therapieprinzips mit intravenöser Applikation. Allergologie 29: 322–331

    Google Scholar 

  • Pleskow WW, Stevenson DD, Mathison DA, Simon RA, Schatz M, Zeiger RS (1982) Aspirin desensitization in aspirin-sensitive asthmatic patients: clinical manifestations and characterization of the refractory period. J Allergy Clin Immunol 69: 11–19

    Google Scholar 

  • Rozsasi A, Polzehl D, Deutschle T, Smith E, Wiesmiller K, Riechelmann H et al. (2008) Long-term treatment with aspirin desensitization: a prospective clinical trial comparing 100 and 300 mg aspirin daily. Allergy 63: 1228–1234

    Google Scholar 

  • Samter M, Beers RF Jr (1967) Concerning the nature of intolerance to aspirin. J Allergy 40: 281–293

    Google Scholar 

  • Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A (2013) Aspirin-exacerbated cutaneous disease. Immunol Allergy Clin North Am 33: 251–262

    Google Scholar 

  • Sanz ML, Gamboa P, de Weck AL (2005) A new combined test with flowcytometric basophil activation and determination of sulfidoleukotrienes is useful for in vitro diagnosis of hypersensitivity to aspirin and other nonsteroidal anti-inflammatory drugs. Int Arch Allergy Immunol 136: 58–72

    Google Scholar 

  • Sanz ML, Gamboa PM, De Weck AL (2008) Cellular tests in the diagnosis of drug hypersensitivity. Curr Pharm Des 14: 2803–2808

    Google Scholar 

  • Schäfer D, Schmid M, Göde UC, Baenkler H (1999) Dynamics of eicosanoids in peripherial blood cells during bronchial provocation in aspirin-intolerant asthmatics. Eur Respir J: 638–646

    Google Scholar 

  • Stevenson DD (1986) Aspirin desensitization. N Engl Reg Allergy Proc 7: 101–104

    Google Scholar 

  • Stevenson DD (2009) Aspirin sensitivity and desensitization for asthma and sinusitis. Curr Allergy Asthma Rep 9: 155–163

    Google Scholar 

  • Stevenson DD, Kowalski ML (2013) A dedication to Andrew Szczeklik, MD. Immunol Allergy Clin North Am 33: xi–xii

    Google Scholar 

  • Stevenson DD, Pleskow WW, Simon RA, Mathison DA, Lumry WR, Schatz M et al. (1984) Aspirin-sensitive rhinosinusitis asthma: a double-blind crossover study of treatment with aspirin. J Allergy Clin Immunol 73: 500–507

    Google Scholar 

  • Stevenson DD, Hankammer MA, Mathison DA, Christiansen SC, Simon RA (1996) Aspirin desensitization treatment of aspirin-sensitive patients with rhinosinusitis-asthma: long-term outcomes. J Allergy Clin Immunol 98: 751–758

    Google Scholar 

  • Stuck BA, Bachert C, Federspil P, Hosemann W, Klimek L, Moesges R et al. (2012) Leitlinie «Rhinosinusitis”-Langfassung. Allergo J 21: 165–186

    Google Scholar 

  • Szczeklik A, Nizankowska E, Duplaga M (2000) Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma. Eur Respir J 16: 432–436

    Google Scholar 

  • Szczeklik A, Nizankowska E, Sanak M, Swierczynska M (2001) Aspirin-induced rhinitis and asthma. Curr Opin Allergy Clin Immunol 1: 27–33

    Google Scholar 

  • Szczeklik A, Sanak M, Nizankowska-Mogilnicka E, Kielbasa B (2004) Aspirin intolerance and the cyclooxygenase-leukotriene pathways. Curr Opin Pulm Med 10: 51–56

    Google Scholar 

  • Umbreit C, Virchow JC, Thorn C, Hormann K, Klimek L, Pfaar O (2010) Analgetikaintoleranz. Ein häufiges interdisziplinäres Krankheitsbild. Internist 51: 1196–1198

    Google Scholar 

  • Wedi B, Kapp A (2000) Aspirin induced adverse skin reactions: new pathophysiological aspects. Thorax 55 (Suppl 2): S70–71

    Google Scholar 

  • White AA, Stevenson DD (2013) Aspirin desensitization in aspirin-exacerbated respiratory disease. Immunol Allergy Clin North Am 33: 211–222

    Google Scholar 

  • Widal F, Abrami P, Lermoyez J (1993) Anaphylaxie et idiosyncrasie. 1992 [Anaphylaxis and idiosyncrasy. 1992]. Allergy Proc 14: 373–6; discussion 1–2

    Google Scholar 

  • Zeiss CR, Lockey RF (1976) Refractory period to aspirin in a patient with aspirin-induced asthma. J Allergy Clin Immunol 57: 440–448

    Google Scholar 

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Klimek, L., Harai, C., Pfaar, O. (2016). Adaptive Desaktivierung bei Analgetikaintoleranz. In: Biedermann, T., Heppt, W., Renz, H., Röcken, M. (eds) Allergologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37203-2_56

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  • DOI: https://doi.org/10.1007/978-3-642-37203-2_56

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