Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Feb 21;328(7437):434.
doi: 10.1136/bmj.328.7437.434.

Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice

Christine Jenkins  1 , John Costello, Linda Hodge
Affiliations

Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice

Christine Jenkins et al. BMJ. .

Abstract

Objective: To reassess the prevalence of aspirin induced asthma and other issues related to the syndrome.

Data sources: Biosis, SciSearch (1990 to March 2002), Embase (1974 to March 2002), Medline (1966 to March 2002), Toxline, Derwent Drug File (1964 to March 2002), Conference Papers Index and Inside Conferences, Int'l Pharmaceutical Abstracts, Pharma-Online (1978 to March 2002).

Selection criteria: Study type, patient population, and outcome measures. Review was restricted to respiratory responses to analgesics available without prescription.

Results: The prevalence of aspirin induced asthma was highest when determined by oral provocation testing (adults 21%, 95% confidence interval 14% to 29%; children 5%, 0% to 14%) than by verbal history (adults 3%, 2% to 4%; children 2%, 1% to 3%). Cross sensitivity to doses of over the counter non-steroidal anti-inflammatory drugs was present in most patients with aspirin induced asthma: ibuprofen, 98%; naproxen, 100%; and diclofenac, 93%. The incidence of cross sensitivity to paracetamol among such patients was only 7%.

Conclusions: Aspirin induced asthma in adults is more prevalent than previously suggested. When there is a clinical necessity to use aspirin or a non-steroidal anti-inflammatory drug and there is uncertainty about safety, oral provocation testing should be performed.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Inclusion of studies
Fig 2
Fig 2
Relation between aspirin provoking dose and frequency of cross sensitivity to paracetamol (reproduced from Settipane et al 1995 with permission of Mosby)
Fig 3
Fig 3
Duration of aspirin induced and paracetamol induced bronchospastic reactions (reproduced from Settipane et al 1995 with permission of Mosby)
See this image and copyright information in PMC

Comment in

References

    1. Szczeklik A, Gryglewski RJ, Czerniawska-Mysik G. Clinical patterns of hypersensitivity to nonsteroidal anti-inflammatory drugs and their pathogenesis. J Allergy Clin Immunol 1977;60: 276-84. - PubMed
    1. Stevenson DD. Diagnosis, prevention, and treatment of adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs. J Allergy Clin Immunol 1984;74: 617-22. - PubMed
    1. Chandrasekharan NV, Dai H, Roos KL, Evanson NK, Tomsik J, Elton TS, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Nat Acad Sci USA 2002;99: 13926-31. - PMC - PubMed
    1. Schwab JM, Schluesener HJ, Laufer S. COX-3: just another COX or the solitary elusive target of paracetamol? Lancet 2003;361: 981-2. - PubMed
    1. Stevenson DD, Simon RA. Lack of cross-reactivity between rofecoxib and aspirin in aspirin-sensitive patients with asthma. J Allergy Clin Immunol 2001;108: 47-51. - PubMed

Publication types

Substances