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Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease.
Am J Rhinol Allergy. 2018 Jul; 32(4):280-286.AJ

Abstract

Background Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad or aspirin (ASA)-intolerant asthma, affects 7% of asthmatics and has a higher prevalence in those with chronic rhinosinusitis and concomitant nasal polyposis. ASA desensitization with daily ASA therapy is a uniquely beneficial treatment for this disease entity and has been shown to have a significant impact on symptom scores, polyp disease, and need for systemic corticosteroids. However, no long-term studies have demonstrated whether or not ASA therapy remains safe and beneficial for these patients beyond 5-10 years. Objective This study was designed to determine the clinical course of AERD patients desensitized between 1995 and 2010. Methods A 20-question survey was distributed to patients who successfully completed ASA desensitization between January 1995 and April 2010. The questions were designed to assess ASA safety and longitudinal effects of ASA therapy in AERD. Results Of the 285 patients contacted, 92 (32%) completed the questionnaire. Average length of follow-up was 15 years. Of survey responders, 35 patients had discontinued ASA therapy. Although adverse reactions occurred, many also discontinued due to lack of efficacy or need for surgery. For those remaining on ASA (62%), significant improvement in sense of smell, asthma, sinus, and allergic rhinitis scores were noted (P ≤ .001). The majority of ASA patients (68%) had a positive response to treatment and did not require further sinus surgery. However, ASA therapy did not delay the time to next sinus/polyp surgery (P = .27) or reduce total number of sinus surgeries (P = .56) compared to those who stopped treatment. Nearly 85% of AERD patients on ASA therapy found it to be helpful in improving airway disease and quality of life. Conclusion Aspirin desensitization followed by daily maintenance ASA therapy appears to be safe and effective even after 10+ years of continuous use.

Authors+Show Affiliations

1 Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.1 Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.1 Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.1 Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29682983

Citation

Walters, Kristen M., et al. "Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease." American Journal of Rhinology & Allergy, vol. 32, no. 4, 2018, pp. 280-286.
Walters KM, Waldram JD, Woessner KM, et al. Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease. Am J Rhinol Allergy. 2018;32(4):280-286.
Walters, K. M., Waldram, J. D., Woessner, K. M., & White, A. A. (2018). Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease. American Journal of Rhinology & Allergy, 32(4), 280-286. https://doi.org/10.1177/1945892418770260
Walters KM, et al. Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease. Am J Rhinol Allergy. 2018;32(4):280-286. PubMed PMID: 29682983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term Clinical Outcomes of Aspirin Desensitization With Continuous Daily Aspirin Therapy in Aspirin-exacerbated Respiratory Disease. AU - Walters,Kristen M, AU - Waldram,Jeremy D, AU - Woessner,Katharine M, AU - White,Andrew A, Y1 - 2018/04/23/ PY - 2018/4/24/pubmed PY - 2018/11/21/medline PY - 2018/4/24/entrez KW - NSAID intolerance KW - Samter’s triad KW - aspirin desensitization KW - aspirin side effects KW - aspirin-exacerbated respiratory disease KW - aspirin-intolerant asthma KW - chronic rhinosinusitis KW - nasal polyps KW - questionnaire KW - safety KW - survey SP - 280 EP - 286 JF - American journal of rhinology & allergy JO - Am J Rhinol Allergy VL - 32 IS - 4 N2 - Background Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad or aspirin (ASA)-intolerant asthma, affects 7% of asthmatics and has a higher prevalence in those with chronic rhinosinusitis and concomitant nasal polyposis. ASA desensitization with daily ASA therapy is a uniquely beneficial treatment for this disease entity and has been shown to have a significant impact on symptom scores, polyp disease, and need for systemic corticosteroids. However, no long-term studies have demonstrated whether or not ASA therapy remains safe and beneficial for these patients beyond 5-10 years. Objective This study was designed to determine the clinical course of AERD patients desensitized between 1995 and 2010. Methods A 20-question survey was distributed to patients who successfully completed ASA desensitization between January 1995 and April 2010. The questions were designed to assess ASA safety and longitudinal effects of ASA therapy in AERD. Results Of the 285 patients contacted, 92 (32%) completed the questionnaire. Average length of follow-up was 15 years. Of survey responders, 35 patients had discontinued ASA therapy. Although adverse reactions occurred, many also discontinued due to lack of efficacy or need for surgery. For those remaining on ASA (62%), significant improvement in sense of smell, asthma, sinus, and allergic rhinitis scores were noted (P ≤ .001). The majority of ASA patients (68%) had a positive response to treatment and did not require further sinus surgery. However, ASA therapy did not delay the time to next sinus/polyp surgery (P = .27) or reduce total number of sinus surgeries (P = .56) compared to those who stopped treatment. Nearly 85% of AERD patients on ASA therapy found it to be helpful in improving airway disease and quality of life. Conclusion Aspirin desensitization followed by daily maintenance ASA therapy appears to be safe and effective even after 10+ years of continuous use. SN - 1945-8932 UR - https://www.unboundmedicine.com/medline/citation/29682983/Long_term_Clinical_Outcomes_of_Aspirin_Desensitization_With_Continuous_Daily_Aspirin_Therapy_in_Aspirin_exacerbated_Respiratory_Disease_ DB - PRIME DP - Unbound Medicine ER -