Key result
Aspirin desensitization or graded challenge allows the estimated 1.5% of cardiovascular disease patients with reported aspirin hypersensitivity to safely receive necessary aspirin therapy.
Aspirin desensitization is a safe and effective strategy to ensure patients with cardiovascular disease and reported aspirin hypersensitivity receive appropriate antiplatelet therapy.
Supports considering desensitization in CVD patients with reported aspirin hypersensitivity; leaves open need for prospective trials before changing practice.
PURPOSE OF REVIEW: The use of aspirin in coronary artery disease and address the unmet need of aspirin therapy in patients with history of hypersensitivity reactions to aspirin (acetylsalicylic acid; ASA) or other nonsteroidal inflammatory drugs (NSAIDs). RECENT FINDINGS: Aspirin hypersensitivity is reported in 1.5% of patients with cardiovascular disease. However, many of those labeled as allergic to aspirin had experienced side-effects and could be safely treated with aspirin. Those with true hypersensitivity reactions were often not placed on appropriate antiplatelet therapy. A number of protocols of varying complexity exist in the literature for aspirin desensitization. The focus of this review is to identify the types of aspirin reactions that can occur and provide a rational approach to oral aspirin challenge and desensitization. SUMMARY: In summary, with rare exceptions, patients with a history of 'aspirin/NSAID allergy' who need ASA for cardiovascular issues will be able to safely take aspirin either after a graded challenge or desensitization providing a central role of the allergist in the management of these patients.
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Katharine M. Woessner (2015) conducted a review in Cardiovascular disease with aspirin or NSAID hypersensitivity. Aspirin desensitization or graded challenge was evaluated. Aspirin desensitization or graded challenge allows the estimated 1.5% of cardiovascular disease patients with reported aspirin hypersensitivity to safely receive necessary aspirin therapy.
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