Meta-analysis Exploring Sinopulmonary Outcomes of Aspirin Desensitization in Aspirin-Exacerbated Respiratory Disease

Otolaryngol Head Neck Surg. 2021 Jan;164(1):11-18. doi: 10.1177/0194599820932137. Epub 2020 Jun 23.

Abstract

Objective: The objective of this study is to explore the sinopulmonary outcomes of aspirin desensitization through a systematic review and meta-analysis.

Data sources: Embase and OVID Medline databases.

Review methods: A systematic review of published articles on outcomes following aspirin desensitization in any language for relevant articles was performed in February 2019. Outcomes included sinonasal quality-of-life assessment, sense-of-smell scores, FEV-1 (forced expiratory volume in 1 second), and medication/steroid use.

Results: Thirteen studies met the inclusion criteria out of 6055 articles screened. Aspirin desensitization resulted in significant improvement in FEV-1 and reduction in asthma medication/steroid use (P < .05). There was no significant improvement in the sinonasal quality of life of patients who underwent aspirin desensitization (P = .098).

Conclusion: Aspirin desensitization appears to be effective in improving pulmonary outcomes and should be considered in the treatment of patients with aspirin-exacerbated respiratory disease. However, good-quality studies are still needed to determine the ideal protocol tailored to individual patients.

Keywords: AERD; ATA (aspirin-tolerant asthma); NSAID; SNOT-22; Samter’s triad; Sino-Nasal Outcome Test); acetylsalicylic acid; aspirin-induced asthma; aspirin-tolerant asthma; humans; immunologic; nonsteroidal anti-inflammatory drug; oral aspirin desensitization; respiration disorders.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Aspirin / adverse effects*
  • Asthma, Aspirin-Induced / immunology*
  • Asthma, Aspirin-Induced / prevention & control*
  • Desensitization, Immunologic / methods*
  • Drug Hypersensitivity / immunology
  • Humans
  • Quality of Life
  • Respiratory Function Tests

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin