SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
12/28/05
Prognosis of aspirin associated respiratory disease
Summary
Background - In a significant minority of those with persistent asthma (PA), there is a syndrome manifested by prominent triggering of asthma by ingestion of aspirin (and often by NSAID agents), associated chronic rhinitis, hyperplastic sinusitis and nasal polyposis. In this aspirin exacerbated respiratory disease (AERD) is the PA particularly severe?
Findings - Mascia et al of the Univ of Virginia in Charlottesville investigated the incidence of irreversible airways obstruction in a large number PA patients with/without associated AERD. They found that those with AERD- associated asthma were more commonly: 1) diagnosed as having severe asthma (p<0.001); 2) previously intubated (p<0.001); 3) required high dosage inhaled corticosteroids (p<0.001) and 4) required a burst of systemic corticosteroids in the previous 3 months (p<0.001). The post-bronchodilator FEV-1 was also somewhat lower in those with AERD.
The authors concluded that the presence of AERD is associated with greater severity of the concomitant PA and possibly increased airways remodeling.
Reference
J Allergy Clin Immunol 2005;116:970-5 Editor's Comments
The findings described above certainly suggest that the PA associated with AERD tends to be more severe than PA without AERD. Actually, the differences in the mean values for the AERD and non-AERD groups shown above are not that different in this study (the impressive p<0.001 values are likely due to the very large patient group). Nevertheless, one should follow AERD- associated asthma more intensively.
|