Aspirin-sensitive asthma and upper airway diseases

BACKGROUND Aspirin exacerbated respiratory disease (AERD) consists of nasal polyposis, rhinosinusitis, asthma, and aspirin (ASA) sensitivity. OBJECTIVE This article details how to diagnose and treat AERD and describes the procedures associated with ASA challenge and desensitization, benefits associated with ASA desensitization, and appropriate doses for treatment. METHODS Criteria for diagnosis of AERD as well as desensitization protocols for oral ASA challenge and combined intranasal ketorolac and oral ASA challenge, are detailed in this article based on literature review. RESULTS AERD requires a multidimensional approach to treat the disease given the multiple conditions. With successful ASA desensitization and maintenance of ASA administration, all patients are able to achieve ASA tolerance and select patients are able to achieve improvement in clinical markers such as global scores and reduction in use of topical and systemic corticosteroids.