Long-term clinical effects of aspirin-desensitization therapy among patients with poorly controlled asthma and non-steroidal anti-inflammatory drug hypersensitivity: An exploratory study.
BACKGROUND
According to the Global Initiative for Asthma (GINA), the levels of asthma symptom control can be divided into controlled, partially controlled and uncontrolled asthma. Optional therapy for non-steroidal anti-inflammatory drugs (NSAIDs)-hypersensitive asthmatics uses aspirin desensitization, but until now, this therapy is not established in difficult to treat cases. The aim of this study was to evaluate the efficacy of aspirin desensitization in patients with poorly controlled asthma.


METHODS
Patients with poorly controlled asthma, NDAIDs hypersensitivity and aspirin desensitization were included in the retrospective study. The data were compared to those obtained from patients with controlled asthma and aspirin therapy. Lung function, levels of asthma symptom control, asthma medication, the size of nasal polyps (NP) and smell function were evaluated over 18 months.


RESULTS
Thirty-two patients were included in the study (uncontrolled/partially controlled asthma n=12; controlled asthma n=20). After 18 months of follow-up, the patients with poorly controlled asthma had significantly increased forced expiratory volume in 1s (FEV1) values, as compared to the baseline (66-82%; p=0.02), the levels of asthma control improved significantly (p<0.01). The asthma medication was reduced. In the group of controlled asthma the FEV1 values did not increase significantly (91.9-92.4%; p>0.05) and the asthma medication was constant. In relation to nasal parameters the sense of smell improved significantly in both groups, NP-scores did not differ significantly.


CONCLUSIONS
Patients with a poorly controlled asthma and NSAIDs hypersensitivity profit from an add-on aspirin therapy.
Department of Otorhinolaryngology, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: ulrike.foerster@charite.de.
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Förster-Ruhrmann
Department of Otorhinolaryngology, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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Zappe
Department of Otorhinolaryngology, Campus Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 13353 Berlin, Germany.
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Szczepek
Department of Otorhinolaryngology, Campus Virchow, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; Department of Otorhinolaryngology, Campus Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 13353 Berlin, Germany.
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Olze
Department of Allergy and Pulmonology, Johanniterstrasse 1, 14929 Treuenbrietzen, Germany.
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Rabe
Aspirin-exacerbated respiratory disease (AERD); Asthma; GINA; Levels of asthma symptom control; NSAIDs hypersensitivity; NSAIDs sensitive asthma; Nasal polyps; Uncontrolled asthma