Desensitization NSAIDs

In general, treatment of the asthma underlying NSAlDs sensitivity should follow standard asthma guidelines. This type of asthma is often severe and frequently high doses of inhaled corticosteroids and daily doses of oral corticosteroids are necessary. A special treatment option is a chronic desensitization to aspirin [8]. Desensitization and aspirin maintenance is routinely used in some centers for treatment of chronic rhinusinusitis with nasal polyposis. It is the only available procedure which allows AIA patients with ischemic heart disease to use aspirin. During the state of desensitization to aspirin, not only aspirin but almost all strong NSAIDs are tolerated, so desensitization and NSAID maintenance could be used for treatment of rheumatic disease or chronic pain syndromes. 

Patients with aspirin sensitivity can be desensitized. The ease of desensitization correlates with the sensitivity of the patient. Highly sensitive patients who react initially to less than 100 mg aspirin require multiple rechallenges to produce desensitization. Desensitization usually persists for 2 to 5 days following discontinuance, with full sensitivity reestablished within 7 days. Cross-desensitization has been established between aspirin and aU NSAIDs tested to date. Because patients may experience life-threatening reactions, desensitization should be attempted only in a controlled environment by personnel with expertise in handling these patients. In addition, there have been reports of patients who have failed to maintain a desensitized state despite continued aspirin administration. The chronic asthma symptoms have improved markedly in a number of aspirin-sensitive asthmatics who have undergone desensitization. ... 

Successful desensitization of otherwise healthy individuals with multiple NSAID-induced urticaria and angioedema but no underlying skin disorder does not appear to have been reported. 

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