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Effectiveness of endoscopic sinus surgery and aspirin therapy in the management of aspirin-exacerbated respiratory disease.
- Source :
-
Allergy and asthma proceedings [Allergy Asthma Proc] 2021 Mar 01; Vol. 42 (2), pp. 136-141. - Publication Year :
- 2021
-
Abstract
- Background: Aspirin therapy and/or type 2 (T2) biologics are used in the management of aspirin-exacerbated respiratory disease (AERD). Objective: To identify the number of patients with AERD who tolerated aspirin therapy, yet due to persistent symptoms, incorporated T2 biologic management. Methods: A retrospective review was performed between July 2016 and June 2019. Patients with AERD and who underwent endoscopic sinus surgery (ESS), aspirin desensitization (AD), and at least 6 months of aspirin therapy (ATAD) after AD, and who remained biologic-naive up through this timepoint were included in the study. Introduction of a T2 biologic while on ATAD was the primary outcome. The secondary outcome was a change in a validated patient-reported outcome measure for chronic rhinosinusitis score between the postoperative predesensitization timepoint, and the 6-month postdesensitization timepoint, presented as means and compared by using the Student's t-test. Results: A total of 103 patients met inclusion criteria. Two patients (1.9%) ultimately supplemented ATAD with a T2 biologic. The mean outcomes measure test score after 6 months of ATAD for patients who received biologics was 40.5 versus 15 in those who did not receive biologics (p = 0.02). The mean differences between the postoperative predesensitization test score and the 6-month postdesensitization test score for patients who went on to receive biologics was an increase of 13 versus a decrease of 10 for those patients who did not receive biologics (p = 0.12). Conclusion: ESS, coupled with AD and ATAD, was successful in the long-term management of the majority of the patients with AERD, which rarely required the incorporation of T2 biologics. Patient questionnaires, such as outcomes measure test score, may identify aspirin therapy failures and help guide the practitioner in deciding when to introduce T2 biologics into the patient's treatment regimen.
- Subjects :
- Adult
Anti-Inflammatory Agents, Non-Steroidal adverse effects
Anti-Inflammatory Agents, Non-Steroidal immunology
Aspirin adverse effects
Aspirin immunology
Asthma, Aspirin-Induced diagnosis
Asthma, Aspirin-Induced immunology
Biological Products adverse effects
Combined Modality Therapy
Female
Humans
Immune Tolerance
Male
Middle Aged
Retrospective Studies
Time Factors
Treatment Outcome
Anti-Inflammatory Agents, Non-Steroidal administration & dosage
Aspirin administration & dosage
Asthma, Aspirin-Induced therapy
Biological Products therapeutic use
Desensitization, Immunologic adverse effects
Endoscopy adverse effects
Nasal Surgical Procedures adverse effects
Paranasal Sinuses surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1539-6304
- Volume :
- 42
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Allergy and asthma proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 33685558
- Full Text :
- https://doi.org/10.2500/aap.2021.42.210002