Desensitization to acetyl-salicylic acid as a treatment for non-steroid anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease/Desensibilizacion al acido acetil-salicilico como tratamiento para la enfermedad respiratoria exacerbada por antiinflamatorios no esteroides

The coexistence of hypersensitivity to acetyisalicylic acid (ASA) and other NSAIDs with disease of the upper or the lower airways (rhinosinusitis/sinonasal polyposis, or asthma) is defined as NSAIDs-exacerbated respiratory disease. Treatment options include the avoidance of all analgesics that inhib...

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Bibliographic Details
Published in:Iatreia (Medellín, Colombia) Colombia), 2014-07, Vol.27 (3), p.299
Main Authors: Villa, Ricardo Cardona, Zuluaga, Libia Susana Diez, Giraldo, Ruth Elena Ramirez, Caraballo, Jorge Mario Sanchez
Format: Article
Language:Spanish
Subjects:
Analgesics
Asthma
Drug therapy
Health aspects
Immunotherapy
Nonsteroidal anti-inflammatory agents
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Summary:The coexistence of hypersensitivity to acetyisalicylic acid (ASA) and other NSAIDs with disease of the upper or the lower airways (rhinosinusitis/sinonasal polyposis, or asthma) is defined as NSAIDs-exacerbated respiratory disease. Treatment options include the avoidance of all analgesics that inhibit COX-1 or ASA desensitization, continuing its daily consumption. The latter treatment has shown to improve quality of life, reduce the formation of sinonasal polyps, the episodes of sinus infection, the frequency of hospitalizations and surgeries for resection of polyps and the need for systemic steroid treatment. Multiple desensitization schedules have been used, trying to reduce the risk associated with the procedure and the adverse effects of chronic use of ASA. In this paper we present a review of the different methods of desensitization and two illustrative clinical cases to help understand the factors that influence the choice of treatment for these patients. KEYWORDS Allergen: Immunotherapy: Drugs: Drug Adverse Reaction La coexistencia de hipersensibilidad al acido acetil salicilico (ASA) y a otros antiinflamatorios no esteroides (AINE) con enfermedad de la via aerea superior (rinosinusitis/poliposis nasosinusal) o inferior (asma) se denomina enfermedad respiratoria exacerbada por ASA (EREA). Las opciones de tratamiento incluyen la evitacion de todos los analgesicos inhibidores de la ciclooxigenasa l (COX-1) o la desensibilizacion a ASA, continuando su consumo diario. Esta ultima opcion terapeutica ha demostrado mejorar la calidad de vida, reducir la formacion de polipos nasosinusales, los episodios de sinusitis infecciosa, la frecuencia de las hospitalizaciones y de las cirugias para reseccion de polipos; tambien mejora la hiposmia y reduce la necesidad de tratamiento con esteroides sistemicos. Se han usado multiples esquemas de desensibilizacion, tratando de reducir el riesgo asociado con el procedimiento y los efectos adversos derivados del consumo cronico de ASA. En este articulo se presentan una revision de los diferentes esquemas de desensibilizacion y dos casos clinicos ilustrativos que sirven de ejemplo para comprender mejor los factores que influyen en la eleccion del tratamiento para los pacientes con esta enfermedad. PALABRAS CLAVE Alergeno; Inmunoterapia; Medicamentos: Reaccion Adversa al Medicamento
ISSN:0121-0793