Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: A double-blind study - 02/10/14
Abstract |
Background |
Numerous open trials have demonstrated the beneficial clinical effects of aspirin desensitization (AD) in patients with aspirin-induced asthma (AIA). These beneficial effects might be attributable to aspirin's potent anti-inflammatory properties, but that supposition requires further corroboration.
Objective |
We sought to compare the clinical and biochemical responses to chronic oral AD in 20 patients with AIA and 14 patients with aspirin-tolerant asthma (ATA). All of the patients had chronic rhinosinusitis and nasal polyposis, and these responses were investigated in a pilot, double-blind, placebo-controlled study.
Methods |
Twelve patients with AIA and 6 patients with ATA were randomly assigned to receive 624 mg of aspirin, and 8 patients with AIA and 8 patients with ATA received placebo. Both aspirin and placebo were administered once daily for 6 months. Nasal symptoms, Sino-Nasal Outcome Test (SNOT20) scores, peak nasal inspiratory flows, Asthma Control Questionnaire scores, spirometric parameters, peak expiratory flows, blood eosinophilia, and corticosteroid doses were assessed on a monthly basis. Levels of urinary leukotriene E4 and the stable plasma prostaglandin (PG) D2 metabolite 9α,11β-PGF2 were evaluated at baseline and after 1, 3, 5, and 6 months.
Results |
Only the patients with AIA subjected to AD reported improvements in smell and reductions in sneezing and nasal blockade. The SNOT20 and Asthma Control Questionnaire scores of these patients decreased, and their peak nasal inspiratory flows increased. The dosages of inhaled corticosteroids were reduced. There were no changes in leukotriene E4 or 9α,11β-PGF2 levels after AD.
Conclusion |
The clinically beneficial effects of AD on nasal and bronchial symptoms occurred only in the patients with AIA.
Le texte complet de cet article est disponible en PDF.Key words : Aspirin-induced asthma, aspirin-tolerant asthma, oral aspirin desensitization
Abbreviations used : ACQ, AD, AIA, ASA, ATA, CT, cysLT, ICS, L-ASA, LTE4, NSAID, PEF, PG, 9α,11β-PGF2, PNIF, SNOT20, uLTE4
Plan
| Supported by university grant no. K/ZDS/000362 (Ministry of Science and Higher Education of Poland in association with Jagiellonian University). |
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| Disclosure of potential conflict of interest: M. Świerczyńska-Krępa, G. Bochenek, P. Stręk, A. Ćmiel, A. Gielicz, H. Plutecka, and E. Niżankowska-Mogilnicka have received research support from the Ministry of Science and Higher Education of Poland in association with Collegium Medicum Jagiellonian University (grant no. K/ZDS/000362). M. Sanak has received a grant from Switzerland through the Swiss Contribution to the enlarged European Union (PSPB-072/2010) and a grant from Iceland, Liechtenstein, and Norway through the European Economic Area (EEA) U-BIOPPRED, EU, and EFPIA within the Innovative Medicines Initiative (IMI). |
Vol 134 - N° 4
P. 883-890 - octobre 2014 Retour au numéro
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