Howe, R;
Mirakian, RM;
Pillai, P;
Gane, S;
Darby, YC;
Scadding, GK;
(2014)
Audit of nasal lysine aspirin therapy in recalcitrant aspirin exacerbated respiratory disease.
World Allergy Organization Journal
, 7
(1)
, Article 18. 10.1186/1939-4551-7-18.
Preview |
Text
1939-4551-7-18.pdf Download (860kB) | Preview |
Abstract
Background Aspirin – exacerbated respiratory disease can prove difficult to control. Oral aspirin desensitization is effective, but has adverse effects and may not be cardio-protective at the high doses needed. Objective To examine the effectiveness of aspirin administered in lower doses via the nose. Methods An audit of 121 patients with aspirin exacerbated respiratory disease (AERD), 105 of whom were treated with intranasal lysine aspirin in gradually increasing doses following positive lysine aspirin challenge. Results Treatment was associated with subjective symptomatic improvement or stabilization in 60 of 78 patients at 3 months and 19 of 27 at 12 months. Nasal inspiratory peak flow, olfaction, exhaled and nasal nitric oxide levels were significantly improved (p < 0.05 for all). Patients with positive skin prick tests and those with later onset (>40 years) AERD improved more than non-atopics and those with early onset AERD. Asthma outcomes over 1 year were assessed by questionnaire in 22 patients on lysine aspirin and in 20 who were positive on challenge but who either refused treatment or took it only briefly (less than or equal to 3 months). There was a significant decrease in emergency visits (p = 0.0182), hospitalization (p = 0.0074) and oral steroid use (p = 0.004) in those on nasal lysine aspirin for a year. Gastrointestinal side effects occurred in 3.8%, lower than those reported for oral aspirin therapy. Conclusions and Clinical Relevance This form of therapy might reduce the need for expensive monoclonal antibodies in AERD patients.
| Type: | Article |
|---|---|
| Title: | Audit of nasal lysine aspirin therapy in recalcitrant aspirin exacerbated respiratory disease |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/1939-4551-7-18 |
| Publisher version: | http://dx.doi.org/10.1186/1939-4551-7-18 |
| Language: | English |
| Additional information: | © 2014 Howe et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
| Keywords: | Aspirin exacerbated respiratory disease; Lysine aspirin; Nasal polyposis; Late onset asthma |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1471487 |
Archive Staff Only
 |
View Item |
