Low‐dose aspirin desensitization in individuals with aspirin‐exacerbated respiratory disease

Fruth, Kai; Pogorzelski, Benjamin; Schmidtmann, Irene; Springer, J.; Fennan, N.; Fraessdorf, N.; Boessert, A.; Schaefer, Dirk J.; Gosepath, Jan; Mann, Wolf J.

doi:10.1111/all.12131

Cited by 95 publications

(101 citation statements)

References 28 publications

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“…This low-dose protocol was revealed to be safe, with less than 3% of patients in the treatment group complaining about gastric irritations, all of which could continue the treatment after adding a PPI. 1061 With this unprecedented LOE it was shown that 100 mg as a maintenance dose could significantly reduce the clinical key symptoms such as nasal obstruction, discharge, and headache (p = 0.001). QoL was also significantly improved over a 3-year follow-up period in the treatment group (p = 0.03), along with a lower polyp score after 36 months.…”

Section: Viiie10 Crswnp and Aerd Managementmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Viiie10 Crswnp and Aerd Managementmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

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“…The clinical symptoms of urticaria or anaphylaxis usually appear at standard to high doses, which is an important distinction to sensitized individuals having IgE reactions. The dose dependence is also well documented by successful desensitization procedures in various pseudo-allergic reactions [54,55]. In NSAID-related pseudo-allergy, the underlying inflammation and effector cell hyperreactivity influences the clinical severity [56].…”

Section: Relation Of Allergic-immune P-i and Pseudo-allergic Reactimentioning

confidence: 99%

Classification of Drug Hypersensitivity into Allergic, p-i, and Pseudo-Allergic Forms

Pichler

Hausmann²

2016

Int Arch Allergy Immunol

130

125

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Drug hypersensitivity reactions (DHR) are clinically and functionally heterogeneous. Different subclassifications based on timing of symptom appearance or type of immune mechanism have been proposed. Here, we show that the mode of action of drugs leading to immune/inflammatory cell stimulation is a further decisive factor in understanding and managing DHR. Three mechanisms can be delineated: (a) some drugs have or gain the ability to bind covalently to proteins, form new antigens, and thus elicit immune reactions to hapten-carrier complexes (allergic/immune reaction); (b) a substantial part of immune-mediated DHR is due to a typical off-target activity of drugs on immune receptors like HLA and TCR (pharmacological interaction with immune receptors, p-i reactions); such p-i reactions are linked to severe DHR; and (c) symptoms of DHR can also appear if the drug stimulates or inhibits receptors or enzymes of inflammatory cells (pseudo-allergy). These three distinct ways of stimulations of immune or inflammatory cells differ substantially in clinical manifestations, time of appearance, dose dependence, predictability, and cross-reactivity, and thus need to be differentiated.

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“…26 Furthermore, patients with AERD can be successfully desensitized with as little as 81 mg of aspirin per day. 27,28 The aim of the present study was to explore the possible role of platelets in the pathogenesis of AERD under stable conditions. Furthermore, we also assessed platelet activation markers in plasma during an aspirin challenge test.…”

mentioning

confidence: 99%

Platelet activation markers overexpressed specifically in patients with aspirin-exacerbated respiratory disease

Mitsui

Kondo

Hayashi

et al. 2016

Journal of Allergy and Clinical Immunology

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Low‐dose aspirin desensitization in individuals with aspirin‐exacerbated respiratory disease

Abstract: Aspirin desensitization with a maintenance dose of 100 mg daily has a positive impact on nasal polyp relapse and seems to be a safe and suitable therapy to improve clinical complaints and the quality of life of individuals with AERD.

Cited by 95 publications

References 28 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Classification of Drug Hypersensitivity into Allergic, p-i, and Pseudo-Allergic Forms

Platelet activation markers overexpressed specifically in patients with aspirin-exacerbated respiratory disease

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