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Katharine M. Woessner, MD, FAAAAI, Andrew A. White, MD, FAAAAI 

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Presentation on theme: "Katharine M. Woessner, MD, FAAAAI, Andrew A. White, MD, FAAAAI "— Presentation transcript:

1 Evidence-based approach to aspirin desensitization in aspirin-exacerbated respiratory disease 
Katharine M. Woessner, MD, FAAAAI, Andrew A. White, MD, FAAAAI  Journal of Allergy and Clinical Immunology  Volume 133, Issue 1, Pages e9 (January 2014) DOI: /j.jaci Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2 Fig E1 Schematic of the arachidonic acid pathway and associated findings in AERD pathophysiology, with increased levels of cysteinyl leukotrienes and their receptors, underproduction of prostaglandin E2 (PGE2), and effect of aspirin/NSAID inhibition of COX-1 shown. FLAP, 5-lipoxygenase–activating protein; 5-LO, 5-lipoxygeanse; LT, leukotriene; TX, thromboxane. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3 Fig E2 Workflow for a patient with AERD from diagnosis through desensitization. This algorithm outlines the various decision-making points that occur when a patient presents with a history suggestive of AERD. The issues of a negative challenge result, postdesensitization aspirin dosing, and gastrointestinal symptoms are highlighted. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4 Fig E3 Nasal ketorolac and oral aspirin challenge protocol. This table provides details for combining a nasal ketorolac challenge with an oral aspirin challenge for patients with suspected AERD. It is contraindicated in patients with obstructing nasal polyps. A potential advantage is a shift of the respiratory reaction from the lower to the upper respiratory tract, with shortening of the time involved. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

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