Author(s)
Krithika Kuppusamy, BS
Alan Workman, MD
Michael Kohanski, MD
James Palmer, MD, FARS
Nithin Adappa, MD, FARS
John Bosso, MD
Jennifer Douglas, MD
Affiliation(s)
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USADivision of Rhinology, Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, USADepartment of Otolaryngology, Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts, USA;
Abstract:
Objectives: If different aspirin dosages stratified by patient’s gender, age, or menopausal status impacts the outcomes to aspirin desensitization therapy, thereby setting new clinical guidelines for management of these patients.
Methods: We conducted a retrospective chart review of AERD patients at our tertiary care center from 2016-2023. Data included demographics (gender, age, menopausal status), monthly aspirin dosage post-desensitization, and SNOT-22 scores. Aspirin dosages were stratified by menopausal status in women and by age (under/over 50) in men. Group differences were analyzed using ANOVA with Tukey post hoc tests (p < 0.05).
Results: A total of 344 patients were included, with aspirin dosages stratified by menopausal status in women and by age (under/over 50) in men. Men under 50 required significantly higher aspirin dosages compared to men over 50 (mean difference [MD] = 176.86, p < 0.001) and Post-Menopausal women (MD = -257.47, p < 0.001). However, there was no statistically significant difference between men over 50 and Post-Menopausal women (MD = -80.61, p = 0.143), or between men under 50 and Pre/Peri-Menopausal women (MD = -44.43, p = 0.686).
Conclusion: Menopausal status appears to influence aspirin dosage requirements, but these differences may be largely age-related, as similar patterns were observed in men over and under 50. While women generally required lower aspirin dosages across both age groups, gender differences were less pronounced. These findings suggest the need for individualized aspirin desensitization protocols based on both age and menopausal status.