Patient Education

Aspirin-Desensitization for AERD

What is Aspirin Exacerbated Respiratory Disease (AERD)? (Aka Samter’s Triad)
AERD is a chronic inflammatory disorder of the sinuses and lungs. Approximately 40% of patients with asthma, nasal polyps/chronic sinusitis will have AERD. In the past, this disorder was referred to as Samter’s Triad.  Patients with this condition develop nasal polyps and in most cases have persistent asthma. It is usually difficult to treat and often requires oral corticosteroids and sinus surgery to manage the symptoms. Multiple asthma medications may also be required to gain control. In addition to the above, an allergic like reaction to Aspirin and other Non Steroidal anti-inflammatory drugs ( NSAIDS) occurs in AERD patients who typically experience any combination of: nasal congestion, runny nose, watery eyes, flushing of the head and neck, coughing, wheezing, shortness of breath and chest tightness. Less commonly there can also be an accompanying itchy skin rash (hives) present or even stomach pain or nausea.

What is Aspirin Desensitization?
Aspirin Desensitization is an effective therapy that can treat the underlying cause of AERD. Medications and repeated surgical sinus procedures only suppress symptoms. The procedure consists of introducing gradually increasing doses of aspirin in a controlled medical environment, beginning first with a nasal spray formulation of an NSAID and then progressing to oral aspirin. The doses are then slowly increased over 2 days until the full dose is reached and then you are considered desensitized and ready to begin aspirin therapy for AERD.

Is Aspirin Desensitization the right therapy for you?
Patients who have AERD (asthma, nasal polyps/chronic sinusitis and reactions to Aspirin and other NSAIDs) often find relief following Aspirin Desensitization. Patients typically experience the following benefits of treatment:

  1. Less medication ( especially steroids) to control polyps and asthma
  2. Fewer sinus surgeries
  3. Reduced asthma attacks
  4. Less sinus infections
  5. Improved sense of smell

Is the procedure safe?
Yes. Even if you previously had a severe reaction to Aspirin/NSAIDs, this procedure can be performed safely. A nurse will be with you during the challenge and your doctor will be continuously monitoring your condition throughout the procedure. Breathing tests, pulse oximetry (measuring oxygen levels by placing a device on your finger) and vital signs are frequently performed. An intravenous line (I.V) will be placed into your arm so that access for emergency medications is there in case they need to be given. As soon as you begin to have symptoms, you will be given treatment to quickly and effectively reverse the reaction. Many patients do not experience anything more than minor symptoms.

How long will the procedure take?
Desensitization to Aspirin is usually accomplished in a 2 day period. Infrequently, a third day is necessary. After each session, patients are allowed to go home for the day. They must return the next morning until the procedure is completed.