Allergic reactions to nonsteroidal anti-inflammatory drugs: is newer better?

In clinical practice, physicians may find it difficult to recognize the differences between allergic and pseudo-allergic reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) and to manage each type of reaction. This paper reviews all the information presently available in order to clarify main problems related to NSAID reactions and to highlight key strategies to handle these reactions.

Early effects of aspirin desensitization treatment in asthmatic patients with aspirin-exacerbated respiratory disease.

Background: Aspirin (ASA)-exacerbated respiratory disease (AERD) is characterized by aggressive inflammation of the respiratory tract and often requires topical and/or systemic corticosteroids to maintain partial control of this disease. Previous studies have revealed that ASA desensitization and subsequent treatment with ASA is associated with clinical improvement in AERD.

Objective: The aim of the present study was to determine the effect of daily ASA treatment for the first 4 weeks after ASA desensitization.

Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease.

Background: Aspirin desensitization treatment is an option to decrease disease activity and reduce the need for systemic corticosteroids in patients with aspirin-exacerbated respiratory disease (AERD).

Objective: This study was designed to determine whether the clinical courses of patients with AERD improved as early as 6 months after starting aspirin desensitization and to compare this with follow-up evaluations after at least a year.

Methods: Between 1995 and 2000, 172 patients with AERD were admitted to our General Clinical Research Center, were desensitized to and treated with aspirin, were discharged to their home communities, and participated in follow-up interviews and written assessments of their clinical courses.

The natural history and clinical characteristics of aspirin-exacerbated respiratory disease.

Background: Aspirin-exacerbated respiratory disease (AERD) is a clinical syndrome characterized by chronic rhinitis, nasal polyps, asthma, and precipitation of asthma and rhinitis attacks after ingestion of aspirin (ASA) and most nonsteroidal anti-inflammatory drugs (NSAIDs). Most information about the disease in the United States has come from small samples of patients.

Objective: The purpose of this study was to examine the natural history and clinical characteristics of 300 AERD patients, referred to our institution for aspirin desensitization.