Table 1

Prevalence of aspirin induced asthma in adults, analysed by population and test method. Values are numbers (percentages) unless stated otherwise

TrialStudy designStudy populationAuthors' definition of positive responseOral provocation testingOral provocation testing and verbal history of aspirin induced asthmaVerbal history alone
Group 1: unselected asthma population*
Delaney 197612Double blind, placebo controlledOutpatients: bronchodilators and antihistamines withheld 6-12 hours before testing, corticosteroids allowedReduction in FEV1 >=20% from baseline for up to four hours44/230 (19.1)118/304 (38.7)
Weber et al 197915Randomised, single blind, placebo controlledAllergy and asthma clinic: no asthma drugs taken 12 hours before testingAbnormal pulmonary function test results, including reduction in FEV1 >25%15/30 (50)
Stevenson et al 197511Single blind, placebo controlledFemale hospital patients with clinically obvious asthma: put on restricted diet, antihistamines omitted 48 hours before testing, bronchodilator treatment omitted six hours before testingReduction in peak expiratory flow >20%31/122 (24.6)
Spector et al 197914Open challenge, patient reportingHospital (n=20), outpatient (n=35)Reduction in FEV1 >30%9/55 (16); incidence was higher in hospital patients than outpatients (35% v 6%)8/55 (15)
Picardo et al16Open challenge, patient reportingConsecutive sample: hospital (n=39), outpatient (n=35)Reduction in FEV1 >30%14/74 (19)12/74 (16)
Walton and Randle 195726Retrospective, medical recordsPrivate patients visiting allergistBronchospasm55/1775 (3.1)
Castillo and Picado 198618Retrospective, multicentre cohort with questionnaire follow upIntensive care unitNot available36/147 (24.3); 40% in steroid dependent v 19% in non-steroid dependent asthmatic patients
Towns and Mellis 198425Retrospective, medical recordsAsthma clinicNot available24/1205 (2.0)
Fischer et al 198324Retrospective, medical recordsAsthma clinicNot available69/2580 (2.7)
Total % (95% CI)†21.1 (13.6, 28.6)38.7 (33.2, 44.2)2.7 (1.6, 3.8)
Group 2: preselected population with history of aspirin induced asthma ‡
Delaney 197612Double blind, placebo controlledOutpatients: bronchodilators and antihistamines withheld 6-12 hours before testing; corticosteroids allowedReduction in FEV1 >=20% from baseline for up to four hours29/59 (49)
Webber et al 197915Randomised, single blind, placebo controlledAllergy and asthma clinic: no asthma drugs taken 12 hours before testingAbnormal pulmonary function test results, including reduction in FEV1 >25%13/15 (87)
McDonald et al 197210Single blind, controlledAllergy clinicRapid reduction in FEV1 >=20%41/87 (47)
Vally et al 20028Single blind, controlledAllergy and asthma clinic: stable asthma, usual maintenance drug allowedRapid reduction in FEV1 >50%8/42 (19)22/282 (8)#
Stenius and Lemola 197613Single blind, controlledAllergy and asthma clinic: first 12 patients had asthma drugs withdrawn, remainder took usual drugs 1-2 hours before attending clinicReduction in FEV1 >=25% from baseline13/39 (34)20/45 (44)
Nizankowska et al 20009Single blind, controlled retrospective analysisAllergy and asthma clinic patientsRapid reduction in FEV1 >50%7/79 (9)
Falliers 198317Open challengeOutpatientsFEV1 >35%9/11 (82)
Kwoh and Feinstein 19866Three population surveysSurvey 1: metropolitan community, hospital cohort (n=150); survey 2: metropolitan community, members of asthma foundation of Western Australia (n=366); survey 3: rural community of Western Australia (n=1298; asthmatic patients n=128)Not available17/150 (11.3); 48/366 (13.1); 14/128 (10.9)
Total (95% CI)†29.5 (18.2 to 40.8)9.4 (4.7 to 14.1)12.2 (8.0 to 16.4)
Group 3: pre-selected population with no history of sensitivity ‡
Delaney 197612Double blind, placebo controlledOutpatients: bronchodilators and antihistamines withheld 6-12 hours before testing; corticosteroids allowedReduction in FEV1 >=20% from baseline for up to 4 hours15/171 (8.7)
Weber et al15Randomised, single blind, placebo controlledAllergy and asthma clinic: no asthma drugs taken 12 hours before testing.Abnormal pulmonary function test results, including reduction in FEV1 >25%2/15 (13)
Total (95% CI)¶9.0 (3.7 to 14.3)
  • FEV1=forced expiratory volume in one second.

  • *Includes patients with and without a history of aspirin induced asthma and with and without markers of increased risk or likelihood of aspirin induced asthma. †Included patients with history of aspirin induced asthma or with markers of increased risk or likelihood of aspirin induced asthma. ‡Included patients without a history of aspirin induced asthma or without markers of increased risk or likelihood of aspirin induced asthma. §Authors noted this to be underestimation and said real prevalence in population to would be 10-16%. ¶Calculated from pooling incidence rates in individual studies.