Lung Function Variations in AERD vs Aspirin-Tolerant Asthma

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).

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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Reference

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.