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Aspirin tolerance induced in aspirin-sensitive asthmatics
Allergy
|April 1, 1984
Summary
This study demonstrates that aspirin (ASA) desensitization can induce tolerance in most patients with asthma and aspirin sensitivity. Daily administration prolongs tolerance, but sensitivity can recur if dosing intervals increase.
Area of Science:
- Clinical immunology
- Pharmacology
- Respiratory medicine
Background:
- Aspirin sensitivity is a significant concern for patients with asthma.
- Inducing tolerance to aspirin can improve management of these patients.
Purpose of the Study:
- To investigate the efficacy of aspirin desensitization in patients with asthma and aspirin sensitivity.
- To determine the optimal dosing strategy for maintaining aspirin tolerance.
Main Methods:
- Twenty-nine patients with asthma and aspirin sensitivity underwent a desensitization protocol.
- Starting with threshold doses, aspirin (ASA) dosages were doubled daily until tolerance to 600 mg/day was achieved.
- Recurrence of sensitivity after dose interruptions was monitored.
Main Results:
- Twenty-seven out of 29 patients achieved tolerance to 600 mg of aspirin daily.
- Achieving tolerance was more challenging in patients with lower aspirin thresholds.
- Aspirin hypersensitivity recurred in patients when dosing intervals exceeded 24 hours to 9 days.
- Twelve patients tolerated indomethacin challenge after aspirin desensitization.
Conclusions:
- Aspirin desensitization is effective in inducing tolerance in the majority of patients with asthma and aspirin sensitivity.
- Maintaining tolerance requires consistent daily aspirin administration.
- The duration of the refractory period varies, necessitating careful management of dosing intervals.