Lung Function Variations in AERD vs Aspirin-Tolerant Asthma

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FEV1 increased in patients with aspirin-tolerant asthma while on standard asthma treatment but declined in patients with aspirin-exacerbated respiratory disease.

After careful consideration, the American Academy of Allergy, Asthma & Immunology canceled its annual meeting that was to take place in Philadelphia, Pennsylvania from March 13 to 16, because of concerns regarding the coronavirus disease 2019 (COVID-19) outbreak. Although the live events will not proceed as planned, our readers can still find coverage of research that was scheduled to be presented at the meeting.

Patients with aspirin-exacerbated respiratory disease (AERD) present to asthma clinics with a higher forced expiratory volume in 1 second (FEV1) than patients with aspirin-tolerant allergic asthma (ATA). However, patients with ATA have an increase in FEV1 on standard asthma treatment compared with patients with AERD who have a decline in FEV1, according to data intended to be presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Researchers from the Albert Einstein College of Medicine in Bronx, New York, examined the baseline and change in FEV1 in patients with AERD (n=24), a phenotype of adult-onset asthma that commonly features symptoms such as nasal polyposis, chronic rhinosinusitis, and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Baseline and changes in FEV1 in these patients were compared with patients with ATA (n=26). Both groups were examined following standard asthma treatment.

Patients with AERD and ATA were followed for a total of 46 months (interquartile range [IQR], 18-52 months) and 42 months (IQR, 29-62 months), respectively. Baseline values of FEV1 were significantly lower in patients with ATA vs patients with AERD (59% [IQR, 53%-80%] vs 89% [IQR, 66%-99%], respectively; P ≤.01).

There was no significant difference between the AERD and ATA groups in terms of the FEV1 at the end of the follow-up period (82% [IQR, 68%-97%] vs 69% [IQR, 61%-85%], respectively; P =.06). Patients with AERD experienced a -5% (IQR, -8% to 8%) decrease in FEV1, whereas patients in ATA experienced a 6% (IQR, 0%-16%) increase in FEV1 over time (P <.05). The FEV1 increased significantly to 68% at the end of following in patients with (IQR, 61%-85%; P <.05 in comparison to baseline FEV1).

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The researchers concluded that patients with AERD presented to clinics with higher FEV1 than patients with ATA, mostly likely because of the shorter durations of asthma. However, patients with AERD who received standard asthma treatment experienced decreases in FEV1 vs patients with ATA who experienced increases in FEV1.

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Sehanobish E, Beronilla M, Hudes G, Jariwala S. Jerschow E. Lung function change in aspirin exacerbated respiratory disease (AERD) and in aspirin-tolerant asthma patients. J Allergy Clin Immunol. 2020;145(Suppl 2):AB206.