Biologics and Aspirin-Exacerbated Respiratory Disease

Aspirin in palm of hand
Aspirin in palm of hand
A recent survey of patients with aspirin-exacerbated respiratory disease identified trends in patients’ medication use and treatment experience.

The following article is a part of conference coverage from the American Academy of Allergy, Asthma & Immunology Annual Meeting, being held in Phoenix, Arizona, from February 25 to 28, 2022. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AAAAI 2022 Virtual Annual Meeting.

Biologic agents may be useful in the treatment of aspirin-exacerbated respiratory disease (AERD). These and other findings were presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, February 25 to 28.

Investigators sought to characterize the experience of patients with AERD, a disease characterized by asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), and hypersensitivity reactions to cyclooxygenase-1 inhibitors. Toward that end, investigators administered an online questionnaire to 98 patients from the Brigham and Women’s Hospital AERD Registry. Patients were asked to describe their medication history and treatment experience.

Survey results indicated that 53% (n = 52) of patients had used biologics (omalizumab, mepolizumab, reslizumab, benralizumab, or/or dupilumab), with 49% (n = 48) of respondents indicating current use of a respiratory biologic for treatment for AERD. Use of multiple biologics was reported by 20 patients in total.

Discontinuation of biologics was most commonly due to lack of efficacy, with perceived adverse effects rarely noted as a cause. In total, 26 of 30 patients were transitioned to a different biologic after discontinuation, with dupilumab the most popular choice. No patients who started on dupilumab switched to another treatment.  Patients were most likely to note that dupilumab worked “very well” compared with other biologics (OR: 17.58, P < 0.0001).

Currently, respiratory biologics are approved for the treatment of severe asthma and chronic rhinosinusitis with nasal polyps. Efficacy with AERD remains to be elucidated. AERD includes asthma, asthma and chronic rhinosinusitis with nasal polyps, and cyclooxygenase-1 inhibitor-induced hypersensitivity reactions.

“Biologics have an emerging role in the management of AERD, and are generally well-tolerated,” stated the authors. “Biologic efficacy in AERD is variable by agent, though the majority of patients found dipulumab effective.”


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Mullur J, Steger C, Maurer R, Bensko J, Laidlaw T, Buchheit K. Patient-reported therapeutic experiences with biologic agents in aspirin-exacerbated respiratory disease. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 048.