Treatment for AERD: Aspirin Desensitization

By Adem Lewis / in , , , , , , , , /

(bright music) – [Narrator] The
treatment of AERD has evolved significantly
over the years. Before 1980, the only
AERD treatment available was oral corticosteroids. However, long-term use resulted in many serious side effects. Many patients turned to surgery
to get temporary relief, only to have their
polyps quickly regrow unless they returned to
oral corticosteroids. In the early 1980’s,
researchers discovered that patients could be
desensitized to Aspirin, whereby, they would no longer
react to Aspirin or NSAIDs, as long as they
continue to take Aspirin after the desensitization
procedure. Soon after, they noted
that AERD patients who had been desensitized
were having better outcomes. After many years of research, numerous studies have confirmed that a complete sinus surgery following by aspirin
desensitization is the most effective treatment
for reducing the regrowth of new polyps and managing
other AERD symptoms. Optimal treatment for
patients with AERD involves seamless coordination
between the sinus surgeon and the allergist performing
the aspirin desensitization, which is how we’ve
designed treatment at the Penn AERD Center. The first step is to ensure the sinuses are
completely clear. This involves what’s known as a complete endoscopic
sinus surgery where all eight sinuses
are cleared of any polyps. It is important to have
your surgery performed by a physician with
extensive AERD experience, as it is one of the most severe
forms of nasal polyposis. A thorough clean out including
removal of all polyps along the skull base and
frontal sinus is needed in order to give the best results
with aspirin desensitization. After the sinuses
have been cleared, aspirin desensitization
can begin. Aspirin desensitization
consists of introducing gradually increasing
doses of aspirin. First, with an NSAID nasal spray
and then with oral aspirin. The procedure usually
takes two consecutive outpatient days to
complete safely. It is performed in a
controlled medical environment to be able to treat any
symptoms experienced during desensitization. Even if you previously had
severe reactions to aspirin or NSAIDs, aspirin
desensitization can
be performed safely. Throughout the procedure, your doctor will be continuously
monitoring your condition and a nurse will be with
you the entire time. After desensitization, you’ll
take a full adult daily dose of aspirin to
remain desensitized. The process appears to be
the optimal treatment plan for patients with AERD, frequently resulting in
dramatic reduction of symptoms and improved quality of life in the vast majority
of patients. Benefits usually include decreased nasal congestion, no regrowth of nasal polyps, less medication, especially
oral corticosteroids like prednisone to
control polyps and asthma, no further sinus surgeries, reduced asthma attacks, less sinus infections, less antibiotics, improved sense of smell, improved tolerance to alcohol, and improved quality of life. (bright music)

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