Alcohol-induced respiratory symptoms improve after aspirin desensitization in patients with aspirin-exacerbated respiratory disease

Int Forum Allergy Rhinol. 2018 Oct;8(10):1093-1097. doi: 10.1002/alr.22168. Epub 2018 Jul 10.

Abstract

Background: Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic eosinophilic rhinosinusitis, nasal polyps, asthma, and respiratory sensitivity to aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). In addition to sensitivity to aspirin and NSAIDs, the majority of patients with AERD have been reported to have respiratory intolerance associated with the consumption of alcohol.

Methods: A multicenter prospective cohort study was performed. Patients with AERD confirmed by aspirin challenge were eligible to participate. Those who described themselves as able to tolerate alcohol consumption were excluded. Patients underwent aspirin desensitization following endoscopic sinus surgery. A questionnaire was distributed to patients before and after desensitization to determine pre-desensitization and post-desensitization symptoms associated with alcohol ingestion.

Results: Forty-five patients were enrolled and 37 patients completed the study. The most common pre-desensitization symptoms were nasal congestion (95.6%), rhinorrhea (46.7%), and wheezing (40%). Improvement in the ability to tolerate alcohol was noted in 86.5% of participants (95% confidence interval [CI], 75.5% to 97.5%) and 70.3% of participants (95% CI, 55.5% to 85.0%) described desensitization to be "very helpful" or "extremely helpful" for their ability to tolerate alcohol.

Conclusion: The majority of patients with AERD who experience respiratory symptoms with alcohol consumption describe improvement in this domain following aspirin desensitization.

Keywords: AERD; alcohol; aspirin-exacerbated respiratory disease; asthma; chronic rhinosinusitis; polyps.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Aspirin / administration & dosage*
  • Asthma, Aspirin-Induced / etiology
  • Asthma, Aspirin-Induced / pathology
  • Asthma, Aspirin-Induced / prevention & control*
  • Desensitization, Immunologic* / standards
  • Female
  • Food Hypersensitivity / etiology
  • Food Hypersensitivity / pathology
  • Food Hypersensitivity / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin