Aspirin challenge and desensitization: how, when and why.

Area of Science:

• Cardiology
• Allergy and Immunology
• Pulmonology

Background:

• Aspirin use reduces morbidity and mortality in coronary artery disease (CAD).
• Hypersensitivity reactions to aspirin necessitate alternative management strategies.
• Nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD) often require careful aspirin management.

Purpose of the Study:

• To review current approaches to aspirin challenge and desensitization in patients with hypersensitivity reactions.
• To focus on patients with cardiovascular diseases, particularly coronary artery disease (CAD).

Main Methods:

• Literature review of studies on aspirin challenge and desensitization.
• Analysis of recent flowcharts and protocols for aspirin procedures in CAD patients.
• Evaluation of aspirin desensitization efficacy in nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD).

Main Results:

• Aspirin challenge and desensitization are safe for patients with coronary artery disease (CAD), including acute coronary syndrome.
• Established flowcharts now guide aspirin challenge/desensitization in CAD patients with hypersensitivity.
• Aspirin desensitization with continuous therapy is effective for nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD) with uncontrolled asthma or rhinosinusitis.

Conclusions:

• Aspirin desensitization is crucial for secondary prevention of CAD in hypersensitive patients.
• Aspirin desensitization and continuous therapy are effective for nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD).
• Standardized protocols and safety measures are needed for aspirin challenge/desensitization procedures.