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

被引:84
作者
Stevens, Whitney W. [1 ]
Jerschow, Elina [2 ]
Baptist, Alan P. [3 ]
Borish, Larry [4 ,5 ]
Bosso, John V. [6 ]
Buchheit, Kathleen M. [7 ]
Cahill, Katherine N. [8 ]
Campo, Paloma [9 ]
Cho, Seong H. [10 ]
Keswani, Anjeni [11 ]
Levy, Joshua M. [12 ]
Nanda, Anil [13 ,14 ,15 ]
Laidlaw, Tanya M. [7 ]
White, Andrew A. [16 ]
机构
[1] Northwestern Univ, Dept Med, Div Allergy & Immunol, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Montefiore Med Ctr, Albert Einstein Coll Med, Div Allergy & Immunol, Bronx, NY 10467 USA
[3] Univ Michigan, Sch Med, Dept Med, Div Allergy & Clin Immunol, Ann Arbor, MI 48104 USA
[4] Univ Virginia Hlth Syst, Dept Med, Charlottesville, VA USA
[5] Univ Virginia Hlth Syst, Dept Microbiol, Charlottesville, VA USA
[6] Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Div Rhinol, Philadelphia, PA 19104 USA
[7] Brigham & Womens Hosp, Dept Med, Div Allergy & Clin Immunol, 75 Francis St, Boston, MA 02115 USA
[8] Vanderbilt Univ, Med Ctr, Dept Med, Div Allergy Pulm & Crit Care Med, Nashville, TN USA
[9] IBIMA Hosp Reg Univ Malaga, Allergy Unit, Malaga, Spain
[10] Univ S Florida, Div Allergy & Immunol, Morsani Coll Med, Tampa, FL 33620 USA
[11] George Washington Univ, Sch Med & Hlth Sci, Dept Med, Div Allergy Immunol, Washington, DC 20052 USA
[12] Emory Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Atlanta, GA USA
[13] Asthma & Allergy Ctr, Lewisville, TX USA
[14] Asthma & Allergy Ctr, Flower Mound, TX USA
[15] Univ Texas Southwestern Med Ctr Dallas, Div Allergy & Immunol, Dallas, TX 75390 USA
[16] Scripps Clin, Div Allergy Asthma & Immunol, San Diego, CA USA
关键词
Aspirin-exacerbated respiratory disease; AERD; NSAID-exacerbated respiratory disease; Samter triad; aspirin desensitization;
D O I
10.1016/j.jaci.2020.10.043
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:827 / 844
页数:18
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