Alcohol Intolerance in Patients With Aspirin Exacerbated Respiratory Disease

Aspirin in palm of hand
Aspirin in palm of hand
Patients with AERD are at high risk for alcohol intolerance, although biologics and aspirin desensitization may reduce this risk.

Patients with aspirin-exacerbated respiratory disease (AERD) have a high risk for alcohol intolerance, although biologics and aspirin desensitization may rectify alcohol intolerance in this group of patients, according to systematic review findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held in Philadelphia, Pennsylvania, September 10 to 14, 2022.

Alcohol intolerance among those with AERD has been noted in published reports. Seeking to determine whether a true correlation existed between AERD and alcohol intolerance, researchers conducted a systematic review to determine if this correlation could be confirmed as well as the effect of medical therapy on alcohol tolerance in patients with AERD.

The researchers conducted a systematic review of observational studies (OS) from Embase, EBSCO, PubMed, Scopus, Google Scholar, and gray literature from 1968 to 2021 A total of 845 studies were identified, with 8 ultimately meeting the inclusion criteria of describing AERD symptomatology sparked by alcohol intake. The primary outcome was an association between alcohol intolerance and AERD symptoms; improved alcohol tolerance after biological therapy and aspirin desensitization was the secondary outcome.

The research analyzed included 4 cohort studies, 3 cross-sectional studies, and 1 case-control, all of which were considered to be medium to high quality. Among these studies were 961 participants with AERD, 66% of whom reported 1 or more sinopulmonary exacerbation following alcohol consumption. Notably, 4 studies reported improvement in alcohol tolerance following 1 biologic and 3 aspirin desensitization.

Based on their review and analysis, researchers concluded that individuals with AERD are at high risk for alcohol intolerance. “However, aspirin desensitization and biologics may improve alcohol tolerance in this population,” the researchers noted.


Candelo E, McCalla MC, Avila-Castaño K, Olomu OU, Lal D, Donaldson AM. Relationship between alcohol intolerance and aspirin exacerbated respiratory disease: systematic review. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P149.