Aspirin sensitivity and desensitization for asthma and sinusitis

• Published in: Current allergy and asthma reports Vol. 9; no. 2; pp. 155 - 163
• Main Author: Stevenson, Donald D.
• Format: Journal Article
• Language: English
• Published: New York Current Science Inc 01.03.2009; Springer Nature B.V
• Subjects: Allergies; Allergology; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Aspirin; Aspirin - administration & dosage; Aspirin - adverse effects; Asthma; Asthma - chemically induced; Asthma - diagnosis; Asthma - therapy; Cyclooxygenase Inhibitors - administration & dosage; Cyclooxygenase Inhibitors - adverse effects; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - etiology; Drug Hypersensitivity - therapy; Humans; Medicine; Medicine & Public Health; Respiratory diseases; Sinusitis - chemically induced; Sinusitis - diagnosis; Sinusitis - therapy; Allergy Clin Immunol; Nimesulide; Etoricoxib; Nasal Polyp; Asthma
• ISSN: 1529-7322; 1534-6315
• DOI: 10.1007/s11882-009-0023-4

NSAIDs—including aspirin (ASA)—that inhibit cyclooxygenase (COX)-1 induce nonallergic hypersensitivity reactions consisting of attacks of rhinitis and asthma. Such reactions occur exclusively in a subset of asthmatic patients who also have underlying nasal polyps and chronic hyperplastic eosinophilic sinusitis. We now refer to their underlying inflammatory disease of the entire respiratory tract as aspirin-exacerbated respiratory disease . This review focuses on descriptions of these patients; methods available to diagnose ASA-exacerbated respiratory disease; the unique ability of all NSAIDs that inhibit COX-1 to cross-react with ASA; lack of cross-reactivity with selective COX-2 inhibitors; an update on pathogenesis; and current thoughts about treatment, including ASA desensitization and daily ingestion of ASA itself.