Aspirin desensitization and biologics in aspirin-exacerbated respiratory disease: Efficacy, tolerability, and patient experience

In this study we surveyed 98 patients with AERD in the Brigham and Women’s Hospital AERD registry. Patients completed an online questionnaire describing their medication history and treatment experience. A total of 52 (53.0%) patients reported a history of use of one or more respiratory biologics (omalizumab, mepolizumab, reslizumab, benralizumab, or dupilumab), and 84 (85.7%) reported undergoing aspirin desensitization. There were 24 patients (24.4%) who reported concurrent use of a biologic and daily aspirin therapy. Compared with those on daily aspirin therapy alone, patients taking a biologic and aspirin therapy concurrently were less likely to report that aspirin was effective for their AERD symptoms. Whereas patients reported varying efficacy with biologics, dupilumab had the highest odds of patients reporting it worked “very well”. We conclude that biologics are emerging as a treatment option for AERD and are generally well tolerated. Biologic efficacy in AERD is variable by agent, though most patients taking dupilumab found it to be effective. Patients on a biologic in conjunction with daily aspirin therapy may represent a more severe subset of AERD for which daily aspirin therapy alone is insufficient. Read more here.