Aspirin Desensitization in the Treatment of Antiphospholipid Syndrome during Pregnancy in ASA‐sensitive Patients

Abstract

Aspirin desensitization may be a safe alternative even during pregnancy if carefully monitored and permit patients with APS to receive treatment with ASA. This would constitute a new indication in pregnant women with APS and ASA sensitivity.

Clinical approach on challenge and desensitization procedures with aspirin in patients with ischemic heart disease and nonsteroidal anti-inflammatory drug hypersensitivity

“…It also does not explain the clinical indications for when to use the tolerance (challenge) test or, instead, desensitization to ASA. In particular, the published series differ in terms of number of patients studied, antihistamine premedication, intervals between ASA doses, total time of administration, cumulative dose reached and time of observation after procedure is finished (Table ).…”

Clinical immunology review series: an approach to desensitization

“…Although there are no controlled clinical trials to validate the dosage regimens employed, there are a number of published case reports/ series supporting the efficacy and safety of this process. Drug desensitization has been carried out successfully for a number of IgE-mediated responses, including penicillins, cephalosporins, carbapenems, insulin and platins, as well as for non-IgE-mediated immediate hypersensitivity reactions including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), radio contrast media and vancomycin [91][92][93][94][95][96][97][98][99][100][101][102]. In view of the potential risk of anaphylaxis, this procedure must be considered following a careful 'risk-benefit' analysis.…”

Outpatient Aspirin Desensitization for Patients With Aspirin Hypersensitivity and Cardiac Disease

“…The final dose was repeated 24 hours later. 33 This report suggests the safety of aspirin desensitization even in pregnancy.…”

“…22,33 In our study, patients were classified as having an immediate IgE-mediated hypersensitivity to aspirin based on their clinical history. Although it was possible that some of the patients who were successfully desensitized may not have had IgE-mediated reactions, commercially available in vitro tests were not available to confirm the presence of aspirin specific IgE antibodies.…”