Treatment of Aspirin Exacerbated Respiratory Disease with a Low Salicylate Diet: A Pilot Crossover Study
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abstract
ObjectiveAspirin exacerbated respiratory disease (AERD) is comprised of aspirin/acetylsalicylic acid (ASA) sensitivity, bronchial asthma, and nasal polyposis. Treatment of this condition is challenging and may include topical/systemic steroids, endoscopic sinus surgery, and/or aspirin desensitization.Study DesignA prospective crossover pilot study (n = 10) was conducted in which patients were randomized into either of 2 groups with 6 weeks of regular diet (R) or 6 weeks of a low salicylate diet (LS).SettingThe study was conducted in a tertiary otolaryngology clinic.SubjectsPatients with AERD were enrolled in the study.MethodsSubjective (Sino‐nasal Outcome Test‐22 [SNOT‐22], Nasal Sinus Symptom Scale [NSSS], and the Asthma Control Questionnaire‐7 [ACQ‐7]) and objective outcome instruments (Peri‐Operative Sinus Evaluation [POSE] and Lund‐Kennedy Endoscopic Score [LKES]) were used to evaluate patients at baseline, 6 weeks (at crossover), and 12 weeks.ResultsWilcoxon rank sum tests demonstrated that patients on the low salicylate diet had improved scores compared to their regular diet when evaluated by 4 of the 5 outcome measures (SNOT‐22 pLS = 0.0059, NSSS pLS = 0.0195, LKES pLS = 0.0039, POSE pLS = 0.005).ConclusionResults of the pilot study indicate that implementation of a low salicylate diet improves the nasal symptoms and nasal endoscopy findings of individuals with AERD. Further research is required to support these findings.
