Hao Xiao, Feng Xu, Qiaoru Jia, Li Zhang, Chuqi Shi, Jintao Du, Hui Yang, Juan Meng
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引用次数: 0
Abstract
Background: Aspirin-exacerbated respiratory disease (AERD) is a chronic eosinophilic inflammatory disorder characterized by asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), and intolerance to cyclooxygenase-1 inhibitors. Intranasal aspirin challenge (IAC) is increasingly used for AERD diagnosis due to its practicality and safety. However, the lack of standardized symptom score criteria and optimal dosage complicates its diagnostic utility.
Objective: To establish symptom score criteria and determine the optimal cumulative dosage for IAC in diagnosing AERD.
Methods: A total of 116 patients with CRSwNP were enrolled, including 58 with AERD and 58 without AERD. Group A (n=70, 35 AERD, 35 non-AERD) was used to establish the symptom score criteria, which were validated in Group B (n=46, 23 AERD, 23 non-AERD). Symptom severity was assessed using a visual analog scale (VAS), and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. The safety and optimal dosage of IAC were also investigated.
Results: The optimal cutoff value for the increase in total VAS (T-VAS) was 7.5 points, with a sensitivity of 80.0% and specificity of 97.1%. A maximal cumulative dosage of 70 mg achieved the highest diagnostic accuracy (91.3%) and sensitivity (87.0%). Nasal congestion and rhinorrhea were the most pronounced symptoms during IAC in AERD patients. IAC was generally well-tolerated, with 4.3% of participants experiencing acute worsening of asthma.
Conclusion: This study identifies a T-VAS increase of 7.5 points and a maximal cumulative dosage of 70 mg as optimal for diagnosing AERD via IAC, providing a reliable, safe, and practical diagnostic approach.
期刊介绍：
JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases.
This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders.
The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.
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