Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory disease

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

“…La dosis de mantenimiento recomendada en la mayoría de los casos es de 650 mg dos veces al día y reevaluar la eficacia a los tres meses si ha reportado beneficio se deberá continuar, de lo contrario se suspende. 8,9 Los mecanismos implicados en la desensibilización a la aspirina sugieren que se induce un estado de tolerancia temporal a los antiinflamatorios no esteroides con reducción de la expresión de IL-4 y de la activación de STAT-6. 10 En caso de suspender la terapia en menos de tres días puede reiniciarse a la misma dosis; si el paciente suspende el tratamiento de 3 a 5 días debe reintroducirse a dosis de 325 mg con evaluación de la tolerancia; sin embargo, si se suspende más de 5 días se considera pérdida de la tolerancia.…”

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] .…”

“…Other studies have shown the efficiency of AD treatment for control of both upper and lower airway disease [19,[23][24][25][26][27][28][29][30][31][32] . In the study by Stevenson et al [23] , 65 AERD patients were treated with a mean aspirin dose of 1,214 mg/day for a mean duration of 3.1 years.…”

“…The two largest prospective clinical trials on the efficiency of AD were performed by Berges-Gimeno et al which consisted of 172 patients, and Lee et al which consisted of 137 patients [26,27] . In the first study, 126 out of 172 patients took aspirin for at least 1 year.…”