Long‐term Sinonasal Outcomes of Aspirin Desensitization in Aspirin Exacerbated Respiratory Disease

Abstract

Aspirin desensitization following ESS appears to be a well-tolerated and effective adjunctive therapy for long-term control of nasal polyposis in patients with AERD.

Eficacia a largo plazo de la desensibilización a aspirina en enfermedad respiratoria exacerbada por aspirina. Revisión de 2 casos clínicos

“…10 Los beneficios demostrados con la desensibilización a la aspirina incluyen la reducción de: síntomas de rinosinusitis crónica, número de intervenciones quirúrgicas debidas a la poliposis nasal, gravedad del asma, con dosis de 650 mg cada 12 h. Algunos pacientes también muestran estas ventajas con dosis de 325 mg cada 12 h, en menor proporción se exacacerban al reducir la dosis, la que debe incrementarse nuevamente. 11 La principal causa de abandono del tratamiento es la toxicidad gastrointestinal asociada con la ingesta de ácido acetilsalicílico, por lo que se recomienda la prescripción concomitante de protectores de la mucosa gástrica. 11 La enfermedad respiratoria exacerbada por aspirina afecta la calidad de vida de los pacientes y genera un alto costo del tratamiento farmacológico y quirúrgico; por esto se sugiere evaluar la utilidad del protocolo de desensibilización al ácido acetilsalicílico.…”

“…11 La principal causa de abandono del tratamiento es la toxicidad gastrointestinal asociada con la ingesta de ácido acetilsalicílico, por lo que se recomienda la prescripción concomitante de protectores de la mucosa gástrica. 11 La enfermedad respiratoria exacerbada por aspirina afecta la calidad de vida de los pacientes y genera un alto costo del tratamiento farmacológico y quirúrgico; por esto se sugiere evaluar la utilidad del protocolo de desensibilización al ácido acetilsalicílico.…”

Aspirin Desensitization Treatment for the Management of Aspirin-Exacerbated Respiratory Disease

“…Many studies have shown that AD followed by daily aspirin treatment was associated with an improved clinical course in patients with AERD [8,[19][20][21][22][23][24][25][26][27][28][29][30][31][32] . A wide of aspirin dosages (100-1,300 mg/day) were used for the purpose of AD in these studies.…”

“…A wide of aspirin dosages (100-1,300 mg/day) were used for the purpose of AD in these studies. There was varying degree of clinical benefit obtained from AD in different studies; some showing benefit for only control of upper airway disease [8,[20][21][22] and some for both upper and lower airway disease [19,[23][24][25][26][27][28][29][30][31][32] . To our knowledge, in only one study, which was carried out on 10 aspirin sensitive asthma patients by using 500 mg aspirin, AD was found ineffective as measured as an improvement on pulmonary function tests and reduced need for systemic corticosteroids [33] .…”

“…Some AD trials have shown benefit only for the upper airway disease [8,20,22] . In the study by Sweet et al [8] , 35 patients with AERD were continuously treated with a mean dose of 1300 mg/day aspirin and followed-up for 46 months, 30 patients were treated with a mean dose of 1300 mg/day aspirin for 25 months and then followed-up for 32 months, and 42 patients acted as controls and were followedup for 102 months.…”