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Aspirin-induced asthma

MedGen UID:
230819
•Concept ID:
C1319853
•
Disease or Syndrome; Finding
Synonyms: Aspirin Induced Asthma; Aspirin Induced Asthma Syndrome; Aspirin Induced Asthmas; Aspirin-Induced Asthma; Aspirin-Induced Asthma Syndrome; Aspirin-Induced Asthma Syndromes; Aspirin-Induced Asthmas; Asthma Syndrome, Aspirin-Induced; Asthma Syndromes, Aspirin-Induced; Asthma, Aspirin Induced; Asthma, Aspirin-Induced; Asthma, NSAID induced; Asthma, NSAID-induced; Asthmas, Aspirin Induced; Asthmas, Aspirin-Induced; Asthmas, NSAID-induced; Induced Asthma, Aspirin; Induced Asthmas, Aspirin; NSAID-induced Asthma; NSAID-induced Asthmas; Syndrome, Aspirin-Induced Asthma; Syndromes, Aspirin-Induced Asthma
SNOMED CT: Aspirin-induced asthma (407674008)
 
HPO: HP:0012042

Definition

A type of asthma in which aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) that inhibit cyclooxygen-ase 1 (COX-1) exacerbate bronchoconstriction. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAspirin-induced asthma

Conditions with this feature

Asthma, nasal polyps, and aspirin intolerance
MedGen UID:
347198
•Concept ID:
C1859648
•
Disease or Syndrome
Patients with asthma, nasal polyps, and aspirin intolerance may have severe asthma with rhinosinusitis and nasal polyposis, accompanied by hives, flushing, or abdominal pain following the administration of aspirin or nonsteroidal antiinflammatory drugs (NSAIDs). Severe episodes are life-threatening (summary by Arm and Austen, 2002).
See: Condition Record
Asthma, nasal polyps, and aspirin intolerance

Professional guidelines

PubMed

Current complications and treatment of aspirin-exacerbated respiratory disease.
Cook KA, Stevenson DD
Expert Rev Respir Med 2016 Dec;10(12):1305-1316. Epub 2016 Nov 17 doi: 10.1080/17476348.2016.1258306. PMID: 27817219
Management options for patients with aspirin and nonsteroidal antiinflammatory drug sensitivity.
Knowles SR, Drucker AM, Weber EA, Shear NH
Ann Pharmacother 2007 Jul;41(7):1191-200. Epub 2007 Jul 3 doi: 10.1345/aph.1K023. PMID: 17609236
Aspirin-induced asthma: clinical aspects, pathogenesis and management.
Hamad AM, Sutcliffe AM, Knox AJ
Drugs 2004;64(21):2417-32. doi: 10.2165/00003495-200464210-00004. PMID: 15482000

Recent clinical studies

Etiology

Should Biologics Be Used Before Aspirin Desensitization in Aspirin-Exacerbated Respiratory Disease?
Laidlaw TM, White AA
J Allergy Clin Immunol Pract 2024 Jan;12(1):79-84. Epub 2023 Sep 29 doi: 10.1016/j.jaip.2023.09.019. PMID: 37778627Free PMC Article
Recent Updates in Understanding NSAID Hypersensitivity.
Minaldi E, Cahill K
Curr Allergy Asthma Rep 2023 Mar;23(3):181-188. Epub 2023 Feb 9 doi: 10.1007/s11882-023-01064-3. PMID: 36757490
Mepolizumab for chronic rhinosinusitis with nasal polyps: Treatment efficacy by comorbidity and blood eosinophil count.
Bachert C, Sousa AR, Han JK, Schlosser RJ, Sowerby LJ, Hopkins C, Maspero JF, Smith SG, Kante O, Karidi-Andrioti DE, Mayer B, Chan RH, Yancey SW, Chaker AM
J Allergy Clin Immunol 2022 May;149(5):1711-1721.e6. Epub 2022 Jan 7 doi: 10.1016/j.jaci.2021.10.040. PMID: 35007624
Mepolizumab targets multiple immune cells in aspirin-exacerbated respiratory disease.
Buchheit KM, Lewis E, Gakpo D, Hacker J, Sohail A, Taliaferro F, Berreondo Giron E, Asare C, Vukovic M, Bensko JC, Dwyer DF, Shalek AK, Ordovas-Montanes J, Laidlaw TM
J Allergy Clin Immunol 2021 Aug;148(2):574-584. Epub 2021 Jun 16 doi: 10.1016/j.jaci.2021.05.043. PMID: 34144111Free PMC Article
The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunology.
Stevens WW, Jerschow E, Baptist AP, Borish L, Bosso JV, Buchheit KM, Cahill KN, Campo P, Cho SH, Keswani A, Levy JM, Nanda A, Laidlaw TM, White AA
J Allergy Clin Immunol 2021 Mar;147(3):827-844. Epub 2020 Dec 9 doi: 10.1016/j.jaci.2020.10.043. PMID: 33307116Free PMC Article

Diagnosis

Recent Updates in Understanding NSAID Hypersensitivity.
Minaldi E, Cahill K
Curr Allergy Asthma Rep 2023 Mar;23(3):181-188. Epub 2023 Feb 9 doi: 10.1007/s11882-023-01064-3. PMID: 36757490
Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes.
Gans MD, Gavrilova T
Paediatr Respir Rev 2020 Nov;36:118-127. Epub 2019 Oct 9 doi: 10.1016/j.prrv.2019.08.002. PMID: 31678040
Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper.
Kowalski ML, Agache I, Bavbek S, Bakirtas A, Blanca M, Bochenek G, Bonini M, Heffler E, Klimek L, Laidlaw TM, Mullol J, Niżankowska-Mogilnicka E, Park HS, Sanak M, Sanchez-Borges M, Sanchez-Garcia S, Scadding G, Taniguchi M, Torres MJ, White AA, Wardzyńska A
Allergy 2019 Jan;74(1):28-39. Epub 2018 Oct 2 doi: 10.1111/all.13599. PMID: 30216468
Aspirin-Exacerbated Respiratory Disease.
White AA, Stevenson DD
N Engl J Med 2018 Sep 13;379(11):1060-1070. doi: 10.1056/NEJMra1712125. PMID: 30207919
Chronic Rhinosinusitis.
Trikha A, Kingdom T
J Allergy Clin Immunol Pract 2015 Sep-Oct;3(5):821-2; quiz 823. doi: 10.1016/j.jaip.2015.05.021. PMID: 26362554

Therapy

Mepolizumab targets multiple immune cells in aspirin-exacerbated respiratory disease.
Buchheit KM, Lewis E, Gakpo D, Hacker J, Sohail A, Taliaferro F, Berreondo Giron E, Asare C, Vukovic M, Bensko JC, Dwyer DF, Shalek AK, Ordovas-Montanes J, Laidlaw TM
J Allergy Clin Immunol 2021 Aug;148(2):574-584. Epub 2021 Jun 16 doi: 10.1016/j.jaci.2021.05.043. PMID: 34144111Free PMC Article
The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunology.
Stevens WW, Jerschow E, Baptist AP, Borish L, Bosso JV, Buchheit KM, Cahill KN, Campo P, Cho SH, Keswani A, Levy JM, Nanda A, Laidlaw TM, White AA
J Allergy Clin Immunol 2021 Mar;147(3):827-844. Epub 2020 Dec 9 doi: 10.1016/j.jaci.2020.10.043. PMID: 33307116Free PMC Article
Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper.
Kowalski ML, Agache I, Bavbek S, Bakirtas A, Blanca M, Bochenek G, Bonini M, Heffler E, Klimek L, Laidlaw TM, Mullol J, Niżankowska-Mogilnicka E, Park HS, Sanak M, Sanchez-Borges M, Sanchez-Garcia S, Scadding G, Taniguchi M, Torres MJ, White AA, Wardzyńska A
Allergy 2019 Jan;74(1):28-39. Epub 2018 Oct 2 doi: 10.1111/all.13599. PMID: 30216468
Aspirin-Exacerbated Respiratory Disease.
White AA, Stevenson DD
N Engl J Med 2018 Sep 13;379(11):1060-1070. doi: 10.1056/NEJMra1712125. PMID: 30207919
Chronic Rhinosinusitis.
Trikha A, Kingdom T
J Allergy Clin Immunol Pract 2015 Sep-Oct;3(5):821-2; quiz 823. doi: 10.1016/j.jaip.2015.05.021. PMID: 26362554

Prognosis

Dupilumab rapidly improves eustachian tube dysfunction and otologic symptoms in aspirin-exacerbated respiratory disease.
Mullur J, Lundberg M, Maurer R, Laidlaw TM, Buchheit KM
Allergy Asthma Proc 2024 Nov 1;45(6):421-425. doi: 10.2500/aap.2024.45.240047. PMID: 39517071Free PMC Article
Inflammatory heterogeneity in aspirin-exacerbated respiratory disease.
Scott WC, Cahill KN, Milne GL, Li P, Sheng Q, Huang LC, Dennis S, Snyder J, Bauer AM, Chandra RK, Chowdhury NI, Turner JH
J Allergy Clin Immunol 2021 Apr;147(4):1318-1328.e5. Epub 2020 Nov 12 doi: 10.1016/j.jaci.2020.11.001. PMID: 33189729Free PMC Article
Asthma pharmacotherapy: an update on leukotriene treatments.
Trinh HKT, Lee SH, Cao TBT, Park HS
Expert Rev Respir Med 2019 Dec;13(12):1169-1178. Epub 2019 Sep 26 doi: 10.1080/17476348.2019.1670640. PMID: 31544544
Potential Biomarkers for NSAID-Exacerbated Respiratory Disease.
Park H, Choi Y, Jung CG, Park HS
Mediators Inflamm 2017;2017:8160148. Epub 2017 Aug 9 doi: 10.1155/2017/8160148. PMID: 28852271Free PMC Article
Upper airways in aspirin-exacerbated respiratory disease.
Choi JH, Kim JH, Park HS
Curr Opin Allergy Clin Immunol 2015 Feb;15(1):21-6. doi: 10.1097/ACI.0000000000000122. PMID: 25546326

Clinical prediction guides

Quantifying surgical completeness in patients with aspirin exacerbated respiratory disease.
Levin M, Chan Y, Sommer DD, Thamboo A, Lee JM
J Otolaryngol Head Neck Surg 2023 Dec 17;52(1):83. doi: 10.1186/s40463-023-00682-1. PMID: 38105254Free PMC Article
Mepolizumab for chronic rhinosinusitis with nasal polyps: Treatment efficacy by comorbidity and blood eosinophil count.
Bachert C, Sousa AR, Han JK, Schlosser RJ, Sowerby LJ, Hopkins C, Maspero JF, Smith SG, Kante O, Karidi-Andrioti DE, Mayer B, Chan RH, Yancey SW, Chaker AM
J Allergy Clin Immunol 2022 May;149(5):1711-1721.e6. Epub 2022 Jan 7 doi: 10.1016/j.jaci.2021.10.040. PMID: 35007624
Asthma pharmacotherapy: an update on leukotriene treatments.
Trinh HKT, Lee SH, Cao TBT, Park HS
Expert Rev Respir Med 2019 Dec;13(12):1169-1178. Epub 2019 Sep 26 doi: 10.1080/17476348.2019.1670640. PMID: 31544544
Woakes' syndrome.
El Fakiri MM, Lakhdar Y, Raji A
BMJ Case Rep 2019 Mar 31;12(3) doi: 10.1136/bcr-2018-229021. PMID: 30936362Free PMC Article
Current complications and treatment of aspirin-exacerbated respiratory disease.
Cook KA, Stevenson DD
Expert Rev Respir Med 2016 Dec;10(12):1305-1316. Epub 2016 Nov 17 doi: 10.1080/17476348.2016.1258306. PMID: 27817219

Recent systematic reviews

Relationship Between Alcohol Intolerance and Aspirin-Exacerbated Respiratory Disease (AERD): Systematic Review.
Candelo E, McCalla M, Valderrama OA, Avila-Castano K, Chelf C, Olomu O, Donaldson AM
Otolaryngol Head Neck Surg 2023 Jul;169(1):12-20. Epub 2023 Jan 29 doi: 10.1002/ohn.248. PMID: 36939486
Management of United Airway Disease Focused on Patients With Asthma and Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review.
Mullol J, Maldonado M, Castillo JA, Miguel-Blanco C, Dávila I, Domínguez-Ortega J, Blanco-Aparicio M
J Allergy Clin Immunol Pract 2022 Sep;10(9):2438-2447.e9. Epub 2022 May 12 doi: 10.1016/j.jaip.2022.04.039. PMID: 35568331
Meta-analysis Exploring Sinopulmonary Outcomes of Aspirin Desensitization in Aspirin-Exacerbated Respiratory Disease.
Chaaban MR, Moffatt D, Wright AE, Cowthran JA, Hsu ES, Kuo YF
Otolaryngol Head Neck Surg 2021 Jan;164(1):11-18. Epub 2020 Jun 23 doi: 10.1177/0194599820932137. PMID: 32571140
Aspirin desensitization therapy in aspirin-exacerbated respiratory disease: a systematic review.
Larivée N, Chin CJ
Int Forum Allergy Rhinol 2020 Apr;10(4):450-464. Epub 2020 Jan 16 doi: 10.1002/alr.22520. PMID: 31951112
Benefits and harms of aspirin desensitization for aspirin-exacerbated respiratory disease: a systematic review and meta-analysis.
Chu DK, Lee DJ, Lee KM, Schünemann HJ, Szczeklik W, Lee JM
Int Forum Allergy Rhinol 2019 Dec;9(12):1409-1419. Epub 2019 Sep 13 doi: 10.1002/alr.22428. PMID: 31518069

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