Key result
ASA desensitization protocols lack large-scale randomized validation and remain largely unapplied despite frequent reported symptoms.
Why the study?
ASA desensitization protocols remain largely unapplied due to a lack of validation from large-scale randomized trials or uniform guideline recommendations, leaving management to individualized approaches.
Do ASA desensitization protocols allow for safe administration of aspirin in patients with atherosclerotic cardiovascular disease and ASA hypersensitivity requiring PCI?
Do ASA desensitization protocols allow for safe administration of aspirin in patients with atherosclerotic cardiovascular disease and ASA hypersensitivity requiring PCI?
ASA desensitization protocols offer a potential strategy for managing ASA hypersensitivity in patients requiring PCI, but their use remains limited due to a lack of large-scale randomized trial validation.
ASA desensitization should not yet alter practice in ASA-hypersensitive PCI patients; leaves open need for large RCTs to validate protocols.
Acetylsalicylic acid (ASA) hypersensitivity still represents one of the major deals for patients with atherosclerotic cardiovascular disease (ASHD), especially for those requiring percutaneous coronary interventions in the absence of validated alternative options. Despite symptoms after ASA administration being reported in 6-20% of cases, true ASA allergy only represents a minority of the patients, pointing to the importance of challenge tests and potential strategies for tolerance induction. ASA desensitization protocols were proposed several decades ago, with accumulating the literature on their use in patients undergoing PCI either for chronic disease or acute coronary syndromes. Nevertheless, the promising results of the studies and meta-analyses have not been validated so far by the support of large-scale randomized trials or unique indications from guidelines. Therefore, ASA desensitization is still largely unapplied, leaving the management of ASA hypersensitivity to the individualized approach of cardiologists.
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Verdoia et al. (2023) conducted a review in Atherosclerotic cardiovascular disease with ASA hypersensitivity. ASA desensitization protocols was evaluated. Despite symptoms after ASA administration being reported in 6-20% of cases, ASA desensitization protocols lack validation from large-scale randomized trials and remain largely unapplied.
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