The role of aspirin desensitization in patients with aspirin-exacerbated respiratory disease (AERD).

INTRODUCTION Aspirin-exacerbated respiratory disease (AERD) consists of a classic tetrad: moderate/severe asthma, chronic rhinosinusitis, nasal polyps, and intolerance to aspirin or other nonsteroidal anti-inflammatory drugs. Clinical control with drugs, surgery, and desensitization are treatment options. OBJECTIVE To evaluate the efficacy and tolerability of aspirin desensitization in patients with AERD. METHODS Periodic symptom assessment and endoscopy in patients with AERD undergoing surgery who were desensitized. RESULTS Seventeen patients were desensitized. Eight patients completed the desensitization and were followed for a minimum of a one-year period (mean 3.1 years). These patients showed improvement in all symptoms. Moreover, surgical reassessment was not indicated in any of these patients and there was a decrease in costs with medication and procedures. Eight patients did not complete desensitization, mainly due to procedure intolerance and uncontrolled asthma, whereas another patient was lost to follow-up. CONCLUSION Aspirin desensitization, when tolerated, was effective in patients with AERD and with poor clinical/surgical response.