Long-term follow-up of patients with aspirin-exacerbated respiratory disease status post-desensitization.

RATIONALE: Aspirin desensitization and continuous daily aspirin is the gold standard treatment for aspirin-exacerbated respiratory disease (AERD). We compared the long-term effects of different maintenance doses of aspirin and assessed the success of bridging AERD subjects for surgery with ibuprofen to prevent losing desensitization.

METHODS: We retrospectively assessed 34 subjects with AERD who successfully underwent aspirin desensitization from 2011-2017. We performed comprehensive medical record reviews and subsequent phone interviews with standardized questionnaire.

RESULTS: Of 34 subjects, 65% were female, with average age of 52.8 years, and average of 3.2 years since desensitization. Subjects reported decrease in frequency of nasal symptoms (p<0.001), asthma (p=0.016), and sinus infections (p<0.001) post-desensitization. Improvements were reported in sense of smell, taste, quality of sleep, and quality of life (p<0.001). Difference in benefits was not observed between subjects on 325 mg compared to 650 mg of daily aspirin. Ten subjects required bridging of aspirin for 15 surgeries, but only 8 of 15 (53%) were bridged. Subjects were bridged with ibuprofen on average 5.5 days before surgery, restarted aspirin on average 1.9 days after surgery, with no incidence of adverse events or loss of desensitization.

CONCLUSIONS: No difference in benefits was observed between 325 mg compared to 650 mg of daily aspirin doses. Bridging AERD patients who require surgery with ibuprofen is safe and effective in maintaining aspirin desensitization.