Aspirin Sensitivity May Mark Severe Asthma

In a new study, researchers from more than 20 hospitals throughout Spain and Latin America found a strong association between patients’ sensitivity to aspirin and asthma severity and the presence of chronic rhinosinusitis (CRS).

To evaluate the presence of aspirin sensitivity and CRS, pulmonologists and ear, nose, and throat specialists from 23 facilities recruited 492 patients, aged 18 to 70 years, who attended outpatient clinics with the diagnosis of asthma for at least 1 year. Aspirin sensitivity was assessed by clinical history and/or asthma challenge, and CRS with nasal polyps was assessed by nasal symptoms, nasal endoscopy, and sinus computed tomography (CT) scans.
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Among 473 evaluable patients, 72 (15 percent) were aspirin sensitive, 14.6 percent had no nasosinal disease, and 12.6 percent experienced non-allergic rhinitis, according to researchers. In addition, 36.8 percent had allergic rhinitis, 16.6 percent had CRS without nasal polyps, and 19.4 percent had CRS with nasal polyps.

“Aspirin sensitivity may be considered a clinical marker for severe asthma, and for the presence of chronic rhinosinusitis with nasal polyps, and a potential marker for united airway disease,” according to Jose Antonio Castillo, MD, a physician in the pneumology service at Chiron Dexeus University Hospital in Barcelona, Spain, and a co-author of the study.

Further, the presence of CRS with nasal polyps was also significantly associated with aspirin sensitivity.  

Aspirin sensitivity was present in 4.5 percent of patients with no nasosinal disease, 18.6 percent of those with nonallergic rhinitis, 9.2 percent with allergic rhinitis, 17.5 percent with CRS with no nasal polyps, and 29.8 percent with CRS and nasal polyps. Patients with aspirin-intolerant asthma also showed significantly higher Lund & McKay CT scores than aspirin-tolerant asthmatic patients, according to the researchers.

The current results may be validated by matching aspirin sensitivity with a biomarker of severe asthma, but are such that they already use asthma sensitivity as a clinical marker of severe asthma, added Dr. Castillo.

The findings were originally presented at the CHEST World Congress of the American College of Chest Physicians, held in Madrid, Spain, from March 21 to March 24.

—Mark McGraw