PMID- 31569308 OWN - NLM STAT- MEDLINE DCOM- 20200601 LR - 20201207 IS - 2042-6984 (Electronic) IS - 2042-6976 (Print) IS - 2042-6976 (Linking) VI - 9 IP - 12 DP - 2019 Dec TI - Endoscopic sinus surgery improves aspirin treatment response in aspirin-exacerbated respiratory disease patients. PG - 1401-1408 LID - 10.1002/alr.22418 [doi] AB - BACKGROUND: Aspirin desensitization and treatment benefits most patients with aspirin-exacerbated respiratory disease (AERD), although some patients fail therapy. Our objective was to assess whether recent endoscopic sinus surgery (ESS) improved aspirin treatment outcomes in AERD patients who initially failed aspirin therapy. METHODS: Outcomes of aspirin desensitization and treatment in AERD patients prospectively enrolled were assessed preoperatively and at 4, 12, and 24 weeks after ESS by determining changes in Asthma Control Test (ACT) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and respiratory function. Biomarkers, including fractional excretion of nitric oxide (FeNO), spirometry, nasal inspiratory peak flow (NPF), immunoglobulin E (IgE), and eosinophil count, were measured. RESULTS: Nineteen patients who benefited (responders) and 21 patients who failed (nonresponders) preoperative aspirin treatment with a distant history of ESS (mean, 48 months) were identified. Nonresponders were more likely to be African American (71%, p < 0.01) and have higher baseline IgE levels (252 kU/L vs 87 kU/L in responders, p < 0.01). 24 of the 40 patients (nine responders and 15 non-responders) required subsequent ESS and underwent another aspirin desensitization 3-4 weeks after ESS. All 24 patients tolerated a second round of aspirin desensitization and treatment. The primary aspirin therapy was associated with a significant increase in IgE in nonresponders, but there was no significant increase in IgE after the second aspirin desensitization and treatment. CONCLUSION: Antecedent ESS enhances aspirin treatment responses in AERD patients and may convert patients who failed aspirin treatment before surgery to a more responsive phenotype after ESS. Patients with higher baseline serum IgE levels may benefit from ESS performed shortly before aspirin desensitization and therapy. CI - (c) 2019 ARS-AAOA, LLC. FAU - Shah, Sharan J AU - Shah SJ AD - Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY. FAU - Abuzeid, Waleed M AU - Abuzeid WM AUID- ORCID: 0000-0003-2489-0514 AD - Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY. FAU - Ponduri, Anusha AU - Ponduri A AD - Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY. FAU - Pelletier, Teresa AU - Pelletier T AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. FAU - Ren, Zhen AU - Ren Z AD - Division of Allergy/Immunology, Department of Medicine, Washington University School of Medicine, St Louis, MO. FAU - Keskin, Taha AU - Keskin T AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. FAU - Roizen, Gigia AU - Roizen G AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. FAU - Rosenstreich, David AU - Rosenstreich D AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. FAU - Ferastraoaru, Denisa AU - Ferastraoaru D AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. FAU - Jerschow, Elina AU - Jerschow E AUID- ORCID: 0000-0002-9066-2483 AD - Division of Allergy & Immunology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY. LA - eng GR - KL2 TR001071/TR/NCATS NIH HHS/United States GR - UL1 TR002556/TR/NCATS NIH HHS/United States GR - 5KL2TR001071/TR/NCATS NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20190930 PL - United States TA - Int Forum Allergy Rhinol JT - International forum of allergy & rhinology JID - 101550261 RN - 0 (Anti-Inflammatory Agents, Non-Steroidal) RN - 37341-29-0 (Immunoglobulin E) RN - R16CO5Y76E (Aspirin) SB - IM MH - Adult MH - Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects MH - Aspirin/*administration & dosage/adverse effects MH - Asthma, Aspirin-Induced/surgery/*therapy MH - *Desensitization, Immunologic MH - *Endoscopy MH - Female MH - Humans MH - Immunoglobulin E/immunology MH - Male MH - Middle Aged MH - *Nasal Surgical Procedures MH - Treatment Outcome PMC - PMC6901758 MID - NIHMS1045953 OTO - NOTNLM OT - AERD OT - aspirin-induced asthma OT - asthma OT - nasal polyps OT - paranasal sinus diseases OT - sinusitis OT - treatment outcome COIS- Conflicts of interest: Waleed M. Abuzeid is a consultant for Medtronic, Inc and Intersect ENT. Elina Jerschow has research support from Cumberland Pharmaceuticals, Inc and serves on the Advisory Board for Sanofi/Regeneron and Genentech. None of these interests are relevant to the present work. Other authors have no conflicts of interest to disclose. EDAT- 2019/10/01 06:00 MHDA- 2020/06/02 06:00 PMCR- 2020/12/01 CRDT- 2019/10/01 06:00 PHST- 2019/05/07 00:00 [received] PHST- 2019/08/04 00:00 [revised] PHST- 2019/08/06 00:00 [accepted] PHST- 2019/10/01 06:00 [pubmed] PHST- 2020/06/02 06:00 [medline] PHST- 2019/10/01 06:00 [entrez] PHST- 2020/12/01 00:00 [pmc-release] AID - 10.1002/alr.22418 [doi] PST - ppublish SO - Int Forum Allergy Rhinol. 2019 Dec;9(12):1401-1408. doi: 10.1002/alr.22418. Epub 2019 Sep 30.