The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunology - 04/03/21
, Elina Jerschow, MD b, Alan P. Baptist, MD, MPH c, Larry Borish, MD d, John V. Bosso, MD e, Kathleen M. Buchheit, MD f, Katherine N. Cahill, MD g, Paloma Campo, MD h, Seong H. Cho, MD i, Anjeni Keswani, MD j, Joshua M. Levy, MD, MPH k, Anil Nanda, MD l, m, Tanya M. Laidlaw, MD f, Andrew A. White, MD nAbstract |
Aspirin-exacerbated respiratory disease (AERD) is characterized by the clinical triad of chronic rhinosinusitis with nasal polyps, asthma, and an intolerance to medications that inhibit the cycloxgenase-1 enzyme. Patients with AERD on average have more severe respiratory disease compared with patients with chronic rhinosinusitis with nasal polyps and/or asthma alone. Although patients with AERD traditionally develop significant upper and lower respiratory tract symptoms on ingestion of cycloxgenase-1 inhibitors, most of these same patients report clinical benefit when desensitized to aspirin and maintained on daily aspirin therapy. This Work Group Report provides a comprehensive review of aspirin challenges, aspirin desensitizations, and maintenance aspirin therapy in patients with AERD. Identification of appropriate candidates, indications and contraindications, medical and surgical optimization strategies, protocols, medical management during the desensitization, and recommendations for maintenance aspirin therapy following desensitization are reviewed. Also included is a summary of studies evaluating the clinical efficacy of aspirin therapy after desensitization as well as a discussion on the possible cellular and molecular mechanisms explaining how this therapy provides unique benefit to patients with AERD.
Le texte complet de cet article est disponible en PDF.Key words : Aspirin-exacerbated respiratory disease, AERD, NSAID-exacerbated respiratory disease, Samter triad, aspirin desensitization
Abbreviations used : AERD, ATAD, COX, CRSwNP, CysLT, FESS, ICS, IV, LTMD, LTRA, PGD2, PGE2, PPI, NSAID, 5-LO
Plan
| Disclosure of potential conflict of interest: W. W. Stevens served on scientific advisory boards for GlaxoSmithKline, Genentech, and Bristol Myers Squibb. E. Jerschow has served on scientific advisory boards for GlaxoSmithKline, Sanofi/Regeneron, and Novartis/Genentech; is a consultant for GlaxoSmithKline, received a research grant from AstraZeneca and Cumberland; and is a National Board of Medical Examiners/United States Medical Licensing Exam committee member. A. P. Baptist reports grant support from AstraZeneca and Novartis. J. V. Bosso has served on scientific advisory boards for GlaxoSmithKline, Sanofi/Regeneron, Novartis, AstraZeneca, and Optinose. K. M. Buchheit has served on scientific advisory boards for Regeneron, Genentech, AstraZeneca, and GlaxoSmithKline. K. N. Cahill has served on scientific advisory boards for Novartis, Regeneron, Teva, GlaxoSmithKline, and Blueprint Medicines. S. H. Cho served on an advisory board for ALK. J. M. Levy has served on scientific advisory boards for AstraZeneca and Regeneron. T. M. Laidlaw has served on scientific advisory boards for GlaxoSmithKline, Sanofi-Genzyme, Optinose, and Regeneron. A. A. White served on speakers bureau for AstraZeneca, Regeneron/Sanofi, and Optinose; on advisory boards for Genentech, Regeneron, and Optinose; received research support from AstraZeneca, and is on the board of directors for the Western Society of Allergy, Asthma, and Immunology. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 147 - N° 3
P. 827-844 - mars 2021 Retour au numéro
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