Self reported prevalence of aspirin-sensitive asthma (asa) in an australian asthmatic cohort

Aspirin and non-steroid anti-inflammatory drugs (NSAIDs) have been associated with the triggering of asthmatic reactions in susceptible individuals. It has been suggested that in Europe and the USA between 5 and 10% of adults with asthma are affected, however there is limited epidemiological data assessing the prevalence and characteristics of these reactions in Australia. Aim: The aim of this study was to determine the prevalence and characteristics of asthmatic reactions triggered by aspirin and NSAIDs in a community-based cohort of Australian asthmatics using a self-administered food allergy questionnaire (FAQ). Methods: A total of 366 adult asthmatics recruited from Perth, Western Australia, completed a previously validated FAQ, which addressed asthmatic reactions to various foods and food chemicals, including medicines. Results: Overall, 10.4 % of respondents indicated aspirin and/or NSAIDs had previously triggered asthmatic reactions in them. These reactions were mainly rapid in onset, taking between 15 min and 1 hr to develop; of a sustained duration, lasting for more than 1 hr; and of moderate severity. Logistic regression analysis suggested a positive association between ASA and atopic status (p = 0.045), the number of asthmatic attacks in the previous 12 months (p = 0.032), and the presence of nasal polyps (p = 0.004). We also found evidence suggesting an association between ASA and asthmatic reactions triggered by sulfite-containing foods (p= 0.041) and monosodium glutamate (p < 0.001). Conclusion: The frequency of ASA in this Australian cohort (10.4 %) is similar to the frequency reported elsewhere. Our data also suggests possible cross-reactivities between asthmatic reactions triggered by aspirin and certain food additives, which requires further investigation.