[Importance of aspirin challenges in patients with NSAID-exacerbated respiratory disease].

Stellenwert von ASS-Provokationen beim Analgetika-Intoleranz-Syndrom.

Angioedema NSAID-induced asthma Nasal polyps Rhinitis Sensitivity and specificity

Journal

HNO

ISSN: 1433-0458

Titre abrégé: HNO

Pays: Germany

ID NLM: 2985099R

Informations de publication

Date de publication:
10 Apr 2024

Historique:

accepted: 02 03 2024

medline: 10 4 2024

pubmed: 10 4 2024

entrez: 10 4 2024

Statut: aheadofprint

Résumé

Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is often characterized by a severe course of chronic rhinosinusitis with nasal polyps (CRSwNP), comorbid asthma, and NSAID hypersensitivity. The gold standard for N-ERD diagnosis is challenge with acetylsalicylic acid (ASA). In expert recommendations, the diagnosis of N-ERD is established based on a plausible positive history of NSAID hypersensitivity and CRSwNP with asthma. The following review describes the performance of ASA challenges and their sensitivity and specificity. It also examines the extent to which a positive history of NSAID hypersensitivity correlates with ASA challenge results in clinical trials and when ASA challenges should be performed. ASA challenges have high sensitivity and specificity. In clinical ASA challenge studies, there is a high concordance between a positive history of NSAID hypersensitivity obtained by rhinologists and the measured data of ASA challenge in patients with CRSwNP and comorbid asthma. Therefore, ASA challenge is primarily indicated in patients with an unclear history of NSAID hypersensitivity. HINTERGRUND: Das Analgetika-Intoleranz-Syndrom (AIS) ist häufig durch schwere Verläufe der chronischen Rhinosinusitis mit nasaler Polyposis (CRSwNP) mit komorbidem Asthma und einer Acetylsalicylsäure(ASS)-Intoleranz gekennzeichnet. Bei Intoleranzreaktionen stellen ASS-Provokationen den Goldstandard der Diagnostik dar. Expertenempfehlungen zufolge liegt ein AIS bei plausibler positiver Anamnese von Intoleranz gegenüber nichtsteroidalen Antirheumatika (NSAR) und einer CRSwNP mit Asthma vor. Im vorliegenden Review wird die Durchführung von ASS-Provokationen sowie deren Sensitivität und Spezifität dargestellt. Des Weiteren wird untersucht, inwieweit eine positive NSAR-Intoleranz-Anamnese mit Ergebnissen von ASS-Provokationen in klinischen Studien übereinstimmt und wann ASS-Provokationen erfolgen sollten. ASS-Provokationen weisen eine hohe Sensitivität und Spezifität auf. In klinischen ASS-Provokationsstudien zeigt sich eine hohe Übereinstimmung zwischen einer von Rhinologen erhobenen positiven NSAR-Intoleranz-Anamnese und den Messdaten von ASS-Provokationen bei Patienten mit einer CRSwNP und einem komorbiden Asthma. Somit sind ASS-Provokationen vorrangig bei unklarer NSAR-Intoleranz-Anamnese indiziert.

Sections du résumé

BACKGROUND BACKGROUND

OBJECTIVE OBJECTIVE

The following review describes the performance of ASA challenges and their sensitivity and specificity. It also examines the extent to which a positive history of NSAID hypersensitivity correlates with ASA challenge results in clinical trials and when ASA challenges should be performed.

RESULTS AND CONCLUSION CONCLUSIONS

ASA challenges have high sensitivity and specificity. In clinical ASA challenge studies, there is a high concordance between a positive history of NSAID hypersensitivity obtained by rhinologists and the measured data of ASA challenge in patients with CRSwNP and comorbid asthma. Therefore, ASA challenge is primarily indicated in patients with an unclear history of NSAID hypersensitivity.

ZUSAMMENFASSUNG UNASSIGNED

HINTERGRUND: Das Analgetika-Intoleranz-Syndrom (AIS) ist häufig durch schwere Verläufe der chronischen Rhinosinusitis mit nasaler Polyposis (CRSwNP) mit komorbidem Asthma und einer Acetylsalicylsäure(ASS)-Intoleranz gekennzeichnet. Bei Intoleranzreaktionen stellen ASS-Provokationen den Goldstandard der Diagnostik dar. Expertenempfehlungen zufolge liegt ein AIS bei plausibler positiver Anamnese von Intoleranz gegenüber nichtsteroidalen Antirheumatika (NSAR) und einer CRSwNP mit Asthma vor.

ZIEL DER ARBEIT UNASSIGNED

Im vorliegenden Review wird die Durchführung von ASS-Provokationen sowie deren Sensitivität und Spezifität dargestellt. Des Weiteren wird untersucht, inwieweit eine positive NSAR-Intoleranz-Anamnese mit Ergebnissen von ASS-Provokationen in klinischen Studien übereinstimmt und wann ASS-Provokationen erfolgen sollten.

ERGEBNISSE UND SCHLUSSFOLGERUNG UNASSIGNED

ASS-Provokationen weisen eine hohe Sensitivität und Spezifität auf. In klinischen ASS-Provokationsstudien zeigt sich eine hohe Übereinstimmung zwischen einer von Rhinologen erhobenen positiven NSAR-Intoleranz-Anamnese und den Messdaten von ASS-Provokationen bei Patienten mit einer CRSwNP und einem komorbiden Asthma. Somit sind ASS-Provokationen vorrangig bei unklarer NSAR-Intoleranz-Anamnese indiziert.

Autres résumés

Type: Publisher (ger)

Identifiants

DOI: 10.1007/s00106-024-01460-9 PMID: 38597968

pubmed: 38597968

doi: 10.1007/s00106-024-01460-9

pii: 10.1007/s00106-024-01460-9

doi:

Types de publication

English Abstract Journal Article Review

Langues

ger

Sous-ensembles de citation

Informations de copyright

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