Clinical and Immunological Efficacy of Aspirin Desensitization in Nasal Polyp Patients with Aspirin-Exacerbated Respiratory Disease

Document Type: Research article

Authors

1 Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Allergy research center, Shiraz University of Medical Sciences, Shiraz

3 Department of Allergy and Clinical Immunology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Allergy research center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

This study aimed to investigate the efficacy and the underlining mechanism of aspirin
desensitization among patients with Aspirin Exacerbated Respiratory Disease (AERD). Thirtyeight
patients, who had undergone an aspirin challenge test and were diagnosed as having
AERD, were engaged in a double-blind randomized clinical trial. They were divided into two
groups—an active group of patients who went through aspirin desensitization, and the control
group, receiving placebo. Clinical symptoms and the quality of life of the patients—in addition
to the levels of interleukin 4 and 5 (IL4), (IL5)—were documented at the beginning of the study
and again after six months of aspirin desensitization. The quality of life of the patients was
significantly higher in the active group after six months (P = 0.001). Medication requirements
and symptom score were manifested to be significantly lower in the active group after six
months than at the beginning of the study (P = 0.005, 0.017 respectively). Forced expiratory
volume in the second one (FEV1) was, also, significantly higher in the active group after six
months of the study (P = 0.032). IL5 was found to be significantly lower in the active group
after six months (P = 0.019). However, no significant difference was observed in the levels
of IL4 between the two groups (P = 0.152). The study revealed that aspirin desensitization
can improve the quality of life of patients with AERD, lessen their symptoms and medication
requirements, lower their levels of IL5, and improve some pulmonary function tests such as
FEV1.

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