European scientists call for more systematic diagnosis of aspirin hypersensitivity

A position paper on the diagnosis of aspirin hypersensitivity by a team of European scientists from the Global Allergy and Asthma European Network (GA²LEN) has just been published on the Allergy Journal website. Designed for health professionals, the guidelines propose detailed protocols for challenge tests. The paper is endorsed by the European Academy of Allergology and Clinical Immunology (EAACI) and GA²LEN partners.

Most people tolerate aspirin very well. For others, however, aspirin and other non-steroidal anti-inflammatory drugs trigger allergy-like asthma, sinusitis or urticaria. Reactions can be as violent and life-threatening as asthma attacks and anaphylaxis.
Hypersensitivity to aspirin has been observed since early 20th century. Today, it is one of the most common adverse reactions to a medicinal product. It is however largely under-diagnosed.

A challenge test is the only way to identify aspirin sensitivity. The patient is administered small doses of aspirin that are regularly increased, under direct supervision of a physician in a clinical environment. Hypersensitivity to aspirin is recognised when the patient’s lung function is depressed by more than 20%.

“We hope this position paper will enable physicians to proceed with diagnosis,” concludes Prof. Szczeklik, the main author of the paper. A long list of non-steroidal, anti-inflammatory drugs for common indications, such as headache, is contraindicated to hypersensitive patients. “A proper diagnosis will have a real benefit for them as they will be directed by their doctors to alternative medication that are completely safe to take, without any side-effect.”

While at least 0.5% of the general population is known to suffer from aspirin sensitivity, asthmatics are especially likely to be affected. According to a recent study, about 20% of asthmatic adults are hypersensitive to aspirin.