For Immediate Release
VICTIMS OF ASPIRIN-INDUCED ASTHMA CAN BE SUCCESSFULLY DESENSITIZED
Patients with aspirin-induced asthma, who constitute from 10% to 20% of the approximately 15 million U.S. asthma sufferers, can be successfully desensitized if they must take the product, according to an article in the November issue of CHEST.
Writing in the monthly peer-reviewed journal of the American College of Chest Physicians, K. Suresh Babu, M.D., D.N.B., along with another colleague from the Department of Cellular and Molecular Biology, University of Southampton, Southampton General Hospital, Southampton, United Kingdom, said that attacks of aspirin-induced asthma are often precipitated by ingesting small amounts of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDS). Within 20 minutes to three hours, patients experience nasal congestion in the upper airway, inflammation in the lower airway, runny eyes, and skin eruptions. Nasal polyps, usually benign nodules in the mucous membrane of the nose, can also be present.
Since asthma is an inflammatory condition of the airways, exposure to aspirin or NSAIDS in certain individuals appears temporarily to accentuate the inflammatory process, leading to asthma exacerbations. The precipitation of an acute attack is similar to an immediate hypersensitivity reaction, which sometimes can be serious or possibly fatal.
"Fifty percent of the patients who have aspirin-induced asthma have chronic, severe, corticosteroid-dependent asthma," said Dr. Babu. "Thirty percent have moderate asthma that can be controlled with inhaled steroids, and the remaining 20% of patients have mild and intermittent asthma."
According to Dr. Babu, chronic persistent inflammation is the hallmark of patients with aspirin-induced asthma. Markers of inflammation are consistently found in their blood, as well as therir nasal and bronchial secretions, along with their bronchial biopsy specimens.
Typically, the problem begins after a viral infection. The symptoms usually start after 10 years of age and peak during the patient's 30's.
Over the long-term, noted Dr. Babu, persons with this problem should be advised to avoid aspirin and products containing aspirin. However, if patients with aspirin-induced asthma have coexistent arthritis or arterial thromboembolic diseases, or have suffered a heart attack and use the analgesic as part of their treatment plan, they can be made to tolerate aspirin.
Dr. Babu believes desensitization plays an especially important role in the management of post-myocardial infarction patients.
Although the precise mechanism of aspirin desensitization is unclear, Dr. Babu noted that, to desensitize, patients should take small incremental doses of aspirin over two to three days, under a doctor's supervision, until they can tolerate 400 to 650 mg of aspirin. The analgesic then can be administered daily, with doses of 100 to 300 mg used for desensitization.
According to Dr. Babu, patients can be successfully desensitized, but they need to take the treatment at proper intervals to maintain their desensitization. If patients discontinue aspirin for some days, then their sensitivity to the drug could return to its previous levels, and that could precipitate an acute asthma attack if they are exposed to the drug.
Aspirin was invented by a German chemist, Felix Hoffmann, 100 years ago as a treatment for his father's arthritis. Since then, aspirin has become one of the world's safest, least expensive, and most consistent analgesics. In the United States, annual consumption of aspirin is approximately 80 billion tablets.
CHEST is published by the American College of Chest Physicians, which represents 15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the U.S. and throughout the world.
Reporters may wish to contact Kimberly Lynch of the ACCP at (847) 498-8341. She can be reached by email at [email protected] for a copy of the article. Dr. Babu can be reached by phone at 44-2380-794196.
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