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The safety and efficacy of aspirin desensitization combined with long-term aspirin therapy in Aspirin-exacerbated respiratory disease

Renjiao L1, Fengming L2

1Department of General Medicine, West China Hospital of Sichuan University, Chengdu, China
2Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, China

J Investig Allergol Clin Immunol 2020; Vol. 30(5)
doi: 10.18176/jiaci.0433

Objectives: To assess the safety and efficacy of aspirin desensitization combined with long-term aspirin therapy in subjects with aspirin-exacerbated respiratory disease (AERD).
Methods: We searched the PUBMED, Ovid and Cochrane Library from inception to October 2018, and we imposed a restriction of English on language of publication. Only randomized controlled trials, parallel or cross-over, were included in which adult subjects with AERD were randomly assigned to receive aspirin desensitization and long-term aspirin therapy or placebo.
Results: A total of 869 citations were retrieved and 6 studies met the criteria for analysis. All studies indicated that either nasal symptoms, or asthma symptoms, or both improved significantly after aspirin desensitization treatment. And most studies indicated a decline of corticosteroid dosage,oral or inhaled. The four studies which documented nasal polyps did not demonstrate a change in nasal polyps with aspirin therapy compared to placebo. Dropout rates in all studies reviewed range from 5.8% to 55.7% and the most common adverse events were gastrointestinal symptoms.
Conclusions: Clearly, aspirin desensitization and treatment are beneficial for AERD patients, with a reduction of nasal symptoms, improvements in asthma control and decrease of daily corticosteroid use, without fatal adverse events. However, long-term side effects of aspirin desensitization and optimal dosage of aspirin merit further investigation.

Key words: AERD, Aspirin desensitization, Efficacy, Adverse events