Aspirin-sensitive rhinosinusitis asthma: A double-blind crossover study of treatment with aspirin

Aspirin Desensitization Treatment for the Management of Aspirin-Exacerbated Respiratory Disease

“…The lack of efficiency for the improvement of lower airway disease in the study by Comert et al could have been attributed to a relatively lower dose of aspirin used, however, in the study by Stevenson et al [21] , in which aspirin doses of 325 mg/day, 1300 mg/ day and 2600 mg/day were used, again the nasal symptoms improved and nasal beclomethasone use reduced with aspirin treatment, but no changes in asthma symptoms, pulmonary functions and antiasthmatic medications were observed. Furthermore, no significant difference between three doses of aspirin with regard to percentage of patients showing improvement was also seen in that study.…”

“…Many studies have shown that AD followed by daily aspirin treatment was associated with an improved clinical course in patients with AERD [8,[19][20][21][22][23][24][25][26][27][28][29][30][31][32] . A wide of aspirin dosages (100-1,300 mg/day) were used for the purpose of AD in these studies.…”

“…A wide of aspirin dosages (100-1,300 mg/day) were used for the purpose of AD in these studies. There was varying degree of clinical benefit obtained from AD in different studies; some showing benefit for only control of upper airway disease [8,[20][21][22] and some for both upper and lower airway disease [19,[23][24][25][26][27][28][29][30][31][32] . To our knowledge, in only one study, which was carried out on 10 aspirin sensitive asthma patients by using 500 mg aspirin, AD was found ineffective as measured as an improvement on pulmonary function tests and reduced need for systemic corticosteroids [33] .…”

“…Furthermore, no significant difference between three doses of aspirin with regard to percentage of patients showing improvement was also seen in that study. The authors explained this finding of lack of efficiency of a combined treatment approach consisting of sphenoethmoidectomy followed by AD, for control of lower airway symptoms, by presence of other asthmogenic pathways unaffected by the sinobronchial reflexes or aspirin [21] .…”

Immunomodulatory Treatments for Aspirin Exacerbated Respiratory Disease

“…In 1984, the first randomized, double-blind, placebo-controlled, crossover study of oral aspirin desensitization followed 25 patients over a period of 3 months. 47 Significant improvement of rhinitis symptoms and reduced need for nasal corticosteroid use was reported. Also, about one-half of the patients experienced an improvement in asthma symptoms.…”