Investigation of the Relationship between Aspirin-Sensitivity and Poor Response to Medical Management in NSAIDs-exacerbated Respiratory Disease Patients with Sinonasal Polyposis.
Aspirin-sensitive
Aspirin-tolerant
Asthma
Chronic rhinosinusitis
N-ERD
Nasal polyposis
SNOT22
Journal
Medical journal of the Islamic Republic of Iran
ISSN: 1016-1430
Titre abrégé: Med J Islam Repub Iran
Pays: Iran
ID NLM: 8910777
Informations de publication
Date de publication:
2023
2023
Historique:
received:
30
12
2021
medline:
17
7
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
epublish
Résumé
NSAID-exacerbated respiratory disease (N-ERD) is a highly heterogeneous disorder with various clinical symptoms. The aspirin challenge test is a gold standard method for its diagnosis, and there are still no reliable in vitro diagnostic biomarkers yet. Oral challenge tests are time-consuming and may be associated with a risk of severe systemic reactions. This study aimed to evaluate whether patients with poor responses to medical management are more susceptible to being aspirin-sensitive. In this cohort study, after CT scanning of all patients and subject selection, conventional medical treatment was started as follows and continued for three consecutive months: at first, saline nose wash twice per day, intranasal beclomethasone spray one puff in each nostril twice per day, montelukast 10 mg tablet once daily, a ten-day course of oral prednisolone starting with the dose of 25 mg per day and taper and discontinued thereafter. Sinonasal outcome test 22 (SNOT22) was used for the evaluation of symptom severity. Statistical analyses were performed with SPSS version 23, and data were analyzed using an independent samples T-test, paired T-test, and Receiver operating curve analysis. 25 males and 53 females were enrolled in this study, with an average age of 41.56 ± 11.74 years old (18-36). Aspirin challenge test results were positive in 29 (37.2%) patients. The average SNOT22 scores before the treatment were 52.97 ± 17.73 and 47.04 ± 18.30 in aspirin-sensitive and aspirin-tolerant patients, respectively, and decreased to 27.41 ± 16.61 and 24.88 ± 16.72 in aspirin-sensitive and aspirin-tolerant patients after the treatment, respectively. There was no significant difference in SNOT22 scores between the groups. The severity of symptoms before treatment and clinical improvement after treatment are not good predictors of N-ERD.
Sections du résumé
Background
UNASSIGNED
NSAID-exacerbated respiratory disease (N-ERD) is a highly heterogeneous disorder with various clinical symptoms. The aspirin challenge test is a gold standard method for its diagnosis, and there are still no reliable in vitro diagnostic biomarkers yet. Oral challenge tests are time-consuming and may be associated with a risk of severe systemic reactions. This study aimed to evaluate whether patients with poor responses to medical management are more susceptible to being aspirin-sensitive.
Methods
UNASSIGNED
In this cohort study, after CT scanning of all patients and subject selection, conventional medical treatment was started as follows and continued for three consecutive months: at first, saline nose wash twice per day, intranasal beclomethasone spray one puff in each nostril twice per day, montelukast 10 mg tablet once daily, a ten-day course of oral prednisolone starting with the dose of 25 mg per day and taper and discontinued thereafter. Sinonasal outcome test 22 (SNOT22) was used for the evaluation of symptom severity. Statistical analyses were performed with SPSS version 23, and data were analyzed using an independent samples T-test, paired T-test, and Receiver operating curve analysis.
Results
UNASSIGNED
25 males and 53 females were enrolled in this study, with an average age of 41.56 ± 11.74 years old (18-36). Aspirin challenge test results were positive in 29 (37.2%) patients. The average SNOT22 scores before the treatment were 52.97 ± 17.73 and 47.04 ± 18.30 in aspirin-sensitive and aspirin-tolerant patients, respectively, and decreased to 27.41 ± 16.61 and 24.88 ± 16.72 in aspirin-sensitive and aspirin-tolerant patients after the treatment, respectively. There was no significant difference in SNOT22 scores between the groups.
Conclusion
UNASSIGNED
The severity of symptoms before treatment and clinical improvement after treatment are not good predictors of N-ERD.
Identifiants
pubmed: 37457420
doi: 10.47176/mjiri.37.63
pmc: PMC10349357
doi:
Types de publication
Journal Article
Langues
eng
Pagination
63Informations de copyright
© 2023 Iran University of Medical Sciences.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
Rhinology. 2020 Feb 20;58(Suppl S29):1-464
pubmed: 32077450
Laryngoscope. 2004 Nov;114(11):1932-5
pubmed: 15510016
Clin Transl Allergy. 2015 Mar 03;5:10
pubmed: 25763179
Pol Arch Intern Med. 2022 Feb 28;132(2):
pubmed: 35226440
Annu Rev Physiol. 2009;71:465-87
pubmed: 19575683
Allergy Asthma Immunol Res. 2011 Jan;3(1):3-10
pubmed: 21217919
Allergy Asthma Immunol Res. 2016 Jul;8(4):298-304
pubmed: 27126722
Ann Allergy Asthma Immunol. 2007 Jul;99(1):13-21
pubmed: 17650824
Allergy. 2003 Nov;58(11):1165-70
pubmed: 14616128
Clin Immunol. 2015 Oct;160(2):349-57
pubmed: 26083948
Am J Rhinol. 2000 Sep-Oct;14(5):279-90
pubmed: 11068652
Allergol Int. 2019 Jul;68(3):289-295
pubmed: 31235242
Curr Allergy Asthma Rep. 2015 Aug;15(8):47
pubmed: 26149590
Expert Rev Respir Med. 2015 Oct;9(5):511-8
pubmed: 26366802
Yonsei Med J. 2009 Dec 31;50(6):744-50
pubmed: 20046412
Front Pharmacol. 2020 Jul 28;11:1147
pubmed: 32848759
Ann Allergy Asthma Immunol. 2008 May;100(5):420-5
pubmed: 18517072
Allergy. 2007 Oct;62(10):1111-8
pubmed: 17521312
J Allergy Clin Immunol. 2011 Oct;128(4):728-32
pubmed: 21868076
Auris Nasus Larynx. 2019 Aug;46(4):526-532
pubmed: 30577986
Ann Allergy Asthma Immunol. 2002 Nov;89(5):474-8
pubmed: 12452205
Iran Red Crescent Med J. 2013 May;15(5):404-8
pubmed: 24349728
Allergy. 2003 Oct;58(10):1064-6
pubmed: 14510727
Laryngoscope. 2015 Aug;125(8):1779-84
pubmed: 25891944
PLoS One. 2014 Dec 23;9(12):e111220
pubmed: 25536158
Am J Rhinol Allergy. 2015 May-Jun;29(3):e63-9
pubmed: 25975240
J Pathol. 2006 Jul;209(3):392-9
pubmed: 16583357
Clin Otolaryngol. 2020 Jul;45(4):574-583
pubmed: 32243094
Am J Rhinol Allergy. 2012 Jan-Feb;26(1):e20-2
pubmed: 22391072
Thorax. 2002 Jul;57(7):569-74
pubmed: 12096197
Rhinology. 2011 Aug;49(3):347-55
pubmed: 21858268
Ann Allergy Asthma Immunol. 2005 Jun;94(6):652-7
pubmed: 15984597
Eur Respir J. 2000 Sep;16(3):432-6
pubmed: 11028656