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Australian Journal of Pharmacy : October 2006
ADVERTORIAL Take aim against pain Appropriate pain relief for patients with asthma: Have you considered aspirin induced asthma? Dr Greg King ResearchLeaderattheWoolcockInstituteof Medical Research, Royal PrinceAlfred Hospital, NSW.The WoolcockInstitute is Australia’s leading respiratory and sleep research organisation. DrKing is alsoStaff Specialist in the Department of Respiratory Medicine at Royal North Shore Hospital, where he runs the asthma service and supervisesthe Respiratory Investigation Unit. Asthma is a common condition affecting more than 2 million Australians.1,2 Many people with asthma are unaware of the association between some analgesics and asthma, potentially exposing themselves to unnecessary risks.2-4 Dr Greg King discusses aspirin induced asthma and provides practical tips to help manage pain in patients with asthma. What is aspirin induced asthma? “Aspirin induced asthma, also referred to as aspirin sensitive asthma or analgesic sensitive asthma, is a distinct clinical syndrome. It can occur as part of a well recognised syndrome called Samter’s triad.5 although it can occur earlier,1,2 ” than men.4 • The only definitive way of diagnosing aspirin induced asthma is via provocation tests such as an oral challenge;2 and the only way to determine the true prevalence is by direct challenge.6 • Up to 2 out of every 10 people with asthma who had aspirin induced asthma diagnosed by oral provocation testing were unaware of their condition before being tested.4 It usually first appears around the age of 30, and tends to affect more women How many people does aspirin induced asthma affect? “Australian surveys of adult asthmatic patients suggest that it might affect only 1 in 10 people with asthma.6 tends to underestimate the prevalence,6,7 But, history alone patients are unaware of this condition and don’t associate the use of a pain reliever with an asthma attack.2-4 primarily because many ” “The only meta-analysis of all published randomised controlled oral provocation studies has shown that aspirin induced asthma is more common than previously thought. It can affect up to 21% of adults and 5% of children with asthma.3 ” • Asthma affects approximately 10% of adults and 20% of children.1,2 Based on the prevalence data from oral provocation studies,3 approximately 420,000 adults and 22,500 children in Australia may have aspirin induced asthma.