Table 2. Conditions Important for Shared Decision-Making
INCS
Delivery
Stent Spray Rinse EDS Drops
Improve quality
of life (QoL) ✔ ✔
Improve
symptoms
✔ ✔ ✔
Improve smell
✔ ✔ ✔ ✔
Reduce need for
surgery
✔ ✔ ✔
Adverse effects No different than placebo.
Additional issues Spray is over the counter, and cost is not prohibitive to most.
Biologics dupilumab omalizumab mepolizumab benralizumab
Improve QoL ✔ ✔
Improve
symptoms
✔ ✔ ✔
Improve smell
✔
Reduce need for
surgery
✔
Adverse effects Not different than placebo.
Additional issues Very costly, needs long term treatment, no comparison with surgery
and uncertain if it should be used with, before, or aer surgery. May
be considered more favorably in those with other comorbidities that
are treated with biologics.
Aspirin therapy after desensitization in patients with AERD
Clinical outcomes
compared to
placebo
• Improves symptoms and quality of life
• Not different than placebo for smell
• May not decrease need for oral corticosteroids (OCS) or rescue
surgery
Adverse effects Bleeding risk and gastrointestinal (GI) side effects more common
than placebo.
Note: For every 10 people treated with ATAD, 1 will have an adverse
sufficiently event enough to stop treatment.
Additional issues Affordable, long term treatment
