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Allergy and Airway |

Aspirin Sensitivity as a Clinical Marker for Severe Asthma and United Airway Disease

Jose Castillo, PhD; Cesar Picado, PhD; Vicente Plaza, PhD; Gustavo Rodrigo, PhD; Berta Juliá, PhD; Joaquim Mullol, PhD
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Hospital U. Quiron Dexeus Barcelona, Sitges, Spain


Chest. 2014;145(3_MeetingAbstracts):17A. doi:10.1378/chest.1822198
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Abstract

SESSION TITLE: Asthma Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Aspirin Exacerbated Respiratory Disease (AERD) is commonly associated with chronic rhinosinusitis with nasal polyps (CRSwNP). Few information is available on the correlation between aspirin sensitivity and severe asthma. The aim of this study was to investigate the association between aspirin sensitivity and severe asthma and the presence of CRSwNP in a cohort of asthmatic patients.

METHODS: In a prospective study carried out in 2010-2011 by pneumonologists and ENT specialists in 23 centres, 492 asthmatic patients (mean age 45(15) yo, 70.5% female) were included according to GINA severity: 17.3% intermittent and 82.7% persistent (mild 24.6%, moderate 31.4%, and severe 26.7%). The frequency of allergic (AR) and non-allergic (NAR) rhinitis and chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps were evaluated according to ARIA and EPOS guidelines. Aspirin sensitivity was assessed by clinical history (anamnesis) and/or aspirin challenge and CRSwNP by nasal symptoms, nasal endoscopy, and sinus CT scan.

RESULTS: 15% (72/473) of asthmatic patients were aspirin sensitive, this condition being strongly associated with asthma severity (4.2% intermittent, OR=1; 23.6% in mild persistent, OR=4.3; 29.2% in moderate persistent, OR=4.3; and 43.1% in severe persistent, OR=7.8; p<0.05). In addition, CRSwNP was highly associated to severe persistent asthma (48%, OR=3.4, p<0.001). The presence of CRSwNP in asthmatic patients was also associated with aspirin sentivitity (38.9%, OR=9.05, p<0.001), showing a higher CT score (p<0.03) than aspirin tolerant asthmatics.

CONCLUSIONS: . Aspirin sensitivity may be considered a clinical marker for severe asthma and for the presence of CRS with nasal polyps, and potentially a marker for united airway disease.

CLINICAL IMPLICATIONS: To contribuit to identify severe asthma and improve the treatment.

DISCLOSURE: The following authors have nothing to disclose: Jose Castillo, Cesar Picado, Vicente Plaza, Gustavo Rodrigo, Berta Juliá, Joaquim Mullol

No Product/Research Disclosure Information

ClinicalTrials.gov ID: NCT01513837


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