Patients who tolerate daily low-dose aspirin may still have Aspirin-Exacerbated Respiratory Disease/Samter’s Triad.

Tolerance of daily low-dose aspirin does not preclude aspirin-exacerbated respiratory disease.

The AERD Center at Brigham and Women’s Hospital in Boston, MA identified a group of 7 AERD/Samter’s Triad patients with recurrent nasal polyps who, at the time of AERD diagnosis, had taken 81mg of aspirin daily for months to years. Although none of them recalled having a respiratory reaction to aspirin, all of them developed reactions on diagnostic aspirin challenge after stopping their daily aspirin for at least 10 days. Four of these patients pursued treatment with high-dose aspirin (at least 325mg twice daily), all of whom experienced improvement in their AERD sinus and asthma symptoms and none of whom required repeat polyp surgery over an average follow-up period of 26 months. This study highlights the need to consider the possibility of AERD in patients with recurrent polyps, even those who appear to tolerate low-dose aspirin.