The Effect of Aspirin on Moderate to Severe Asthmatic Patients with Aspirin Hypersensitivity, Chronic Rhinosinusitis, and Nasal Polyposis.

Saba  Arshi; Sepideh  Darougar; Mohammad  Nabavi; Mohammad Hassan  Bemanian; Morteza  Fallahpour; Sima  Shokri; Javad  Ahmadian; Rasool  Molatefi; Mahsa  Rekabi; Zeinab  Moinfar; Paniz  Hashemitari; Narges  Eslami

doi:10.18502/ijaai.v20i3.6330

Saba Arshi Department of Allergy and Clinical Immunology, Hazrat Rasoul-E-Akram Hospital, Iran University of Medical Science, Tehran, Iran
Sepideh Darougar Department of Pediatrics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
Mohammad Nabavi Department of Allergy and Clinical Immunology, Hazrat Rasoul-E-Akram Hospital, Iran University of Medical Science, Tehran, Iran
Mohammad Hassan Bemanian Department of Allergy and Clinical Immunology, Hazrat Rasoul-E-Akram Hospital, Iran University of Medical Science, Tehran, Iran
Morteza Fallahpour Department of Allergy and Clinical Immunology, Hazrat Rasoul-E-Akram Hospital, Iran University of Medical Science, Tehran, Iran
Sima Shokri Department of Allergy and Clinical Immunology, Hazrat Rasoul-E-Akram Hospital, Iran University of Medical Science, Tehran, Iran
Javad Ahmadian Department of Pediatric, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Rasool Molatefi Department of Pediatrics, Bu Ali Hospital, Ardebil University of Medical Sciences, Ardebil, Iran
Mahsa Rekabi Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Zeinab Moinfar Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
Paniz Hashemitari School of Medicine, Humanitas University, Milan, Italy
Narges Eslami Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijaai.v20i3.6330

Keywords: Aspirin; Asthma; Nasal polyps

Abstract

Asthmatic patients may have aspirin-exacerbated respiratory disease and experience acute dyspnea and nasal symptoms within 3 hours after the ingestion of aspirin. This study aimed to evaluate the effect and outcome of daily low-dose aspirin in the treatment of moderate to severe asthma in patients with concomitant aspirin hypersensitivity and chronic rhinosinusitis with nasal polyposis (CRSwNP). This clinical trial was conducted from February 2014 to February 2015 on 46 adult patients with moderate to severe asthma accompanied by CRSwNP. Patients with a positive aspirin challenge were blindly randomized in three groups receiving placebo/day (A); aspirin 100 mg/day (B); and aspirin 325mg/day (C), respectively. Clinical findings, FEV1 and ACT scores were recorded and compared before, during, and after treatment for 6 months (IRCT2015061521970N2). Of 46 participants at baseline, 30 patients completed this 6-month trial study. The level of asthma control was significant; based on Asthma Control Test (ACT) when comparing the results in groups A and C and also groups B and C, but it was not significant when comparing ACT scores between groups A and B. FEV1 before and after treatment was significant when comparing groups A and B, groups A and C, and groups B and C. To conclude, aspirin desensitization with a daily dose of 325 mg aspirin resulted in the improvement of long-term control of asthma. A daily aspirin dose of 100 mg was not associated with such an increase in ACT score.