Anu Laulajainen-Hongisto1, Heikki Turpeinen2, Seija I Vento3, Jura Numminen4, Johanna Sahlman5, Paula Kauppi2, Paula Virkkula3, Maija Hytönen3, Sanna Toppila-Salmi6. 1. Inflammation Centre, Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: anu.laulajainen-hongisto@hus.fi. 2. Inflammation Centre, Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 4. Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland. 5. Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland. 6. Inflammation Centre, Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Medicum, Haartman Institute, University of Helsinki, Helsinki, Finland.
Abstract
BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (N-ERD) consists of chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and NSAID intolerance. Acetylsalicylic acid treatment after desensitization (ATAD) is a treatment option for uncontrolled N-ERD. OBJECTIVE: To evaluate peroral ATAD's long-term effectiveness on CRSwNP disease control. METHODS: The retrospective data (patient characteristics, sinus surgeries before ATAD, ATAD, follow-up data [2019]) were collected from patient records of 171 patients with N-ERD (102 ATAD patients, 69 controls with CRSwNP+N-ERD without ATAD) who underwent tertiary hospital consultation from 2001 to 2017. Outcome measurements were ATAD discontinuation, revision sinus surgery, and corticosteroid and antibiotic courses for airway infections during 2016-2019. Associations were analyzed by survival and nonparametric methods. RESULTS: The ATAD group had more tissue eosinophilia, symptoms, and sinus surgeries before ATAD than others. The ATAD discontinuation rate was 63%, independent of ATAD dose or duration, usually due to side effects. Compared with the N-ERD group without ATAD, ATAD (mean duration, 2.9 years) did not affect the revision endoscopic sinus surgery rate (P = .21, by the log-rank test) or the number of peroral corticosteroid courses per year (P > .05, by the Mann-Whitney U-test) during the follow-up (mean, 7.6 years) despite the dose or duration of ATAD. CONCLUSIONS: The discontinuation rate of ATAD was high (63%), and ATAD did not affect revision sinus surgery rate nor the need of peroral corticosteroids during follow-up. However, the remaining 37% of the ATAD group did continue the treatment, indicating that they may have benefited from ATAD.
BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (N-ERD) consists of chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and NSAID intolerance. Acetylsalicylic acid treatment after desensitization (ATAD) is a treatment option for uncontrolled N-ERD. OBJECTIVE: To evaluate peroral ATAD's long-term effectiveness on CRSwNP disease control. METHODS: The retrospective data (patient characteristics, sinus surgeries before ATAD, ATAD, follow-up data [2019]) were collected from patient records of 171 patients with N-ERD (102 ATAD patients, 69 controls with CRSwNP+N-ERD without ATAD) who underwent tertiary hospital consultation from 2001 to 2017. Outcome measurements were ATAD discontinuation, revision sinus surgery, and corticosteroid and antibiotic courses for airway infections during 2016-2019. Associations were analyzed by survival and nonparametric methods. RESULTS: The ATAD group had more tissue eosinophilia, symptoms, and sinus surgeries before ATAD than others. The ATAD discontinuation rate was 63%, independent of ATAD dose or duration, usually due to side effects. Compared with the N-ERD group without ATAD, ATAD (mean duration, 2.9 years) did not affect the revision endoscopic sinus surgery rate (P = .21, by the log-rank test) or the number of peroral corticosteroid courses per year (P > .05, by the Mann-Whitney U-test) during the follow-up (mean, 7.6 years) despite the dose or duration of ATAD. CONCLUSIONS: The discontinuation rate of ATAD was high (63%), and ATAD did not affect revision sinus surgery rate nor the need of peroral corticosteroids during follow-up. However, the remaining 37% of the ATAD group did continue the treatment, indicating that they may have benefited from ATAD.
Authors: Markus Jukka Lilja; Anni Koskinen; Paula Virkkula; Seija Inkeri Vento; Jyri Myller; Sari Hammarén-Malmi; Anu Laulajainen-Hongisto; Maija Hytönen; Antti Mäkitie; Jura Numminen; Saara Sillanpää; Hannu Raitiola; Markus Rautiainen; Sanna Katriina Toppila-Salmi Journal: Allergy Rhinol (Providence) Date: 2021-04-26
Authors: Cemal Cingi; Nuray Bayar Muluk; Dimitrios I Mitsias; Nikolaos G Papadopoulos; Ludger Klimek; Anu Laulajainen-Hongisto; Maija Hytönen; Sanna Katriina Toppila-Salmi; Glenis Kathleen Scadding Journal: Front Allergy Date: 2021-02-22