Non-steroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (N-ERD) consists of chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma and NSAID intolerance. Acetylsalicylic acid (ASA) treatment after desensitization (ATAD) is a treatment option for uncontrolled N-ERD.
To evaluate peroral ATAD´s long-term effectiveness on CRSwNP disease control.
Retrospective patient record data collection (patient characteristics, sinus surgeries prior to ATAD, ATAD, follow-up data ) from 171 N-ERD patients (102 ATAD patients, 69 controls with CRSwNP+N-ERD without ATAD) undergoing tertiary hospital consultation at 2001-2017. Outcome measurements were ATAD discontinuation, revision sinus surgery, corticosteroid and antibiotic courses for airway infections 2016-2019. Associations were analyzed by survival and nonparametric methods.
The ATAD group had more tissue eosinophilia, symptoms and sinus surgeries prior to ATAD than others. The ATAD discontinuation rate was 63%, independent of ATAD dose or duration, usually due to side-effects. Compared to the N-ERD group without ATAD, ATAD (mean duration 2.9 years) did not affect the revision ESS rate (p=0.21, by log rank test) or the number of peroral corticosteroid courses/year (p>0.05, by Mann-Whitney U-test) during the follow-up (mean 7.6 years) despite the dose or duration of ATAD.
The discontinuation rate of ATAD was high (63%), and ATAD did not affect revision sinus surgery rate, nor need of peroral corticosteroids during follow-up. However, the remaining 37% of the ATAD group did continue the treatment, indicating they may have benefited from ATAD.
Copyright © 2020. Published by Elsevier Inc.