Aspirin-Exacerbated Respiratory Disease: Prevalence, Diagnosis, Treatment, and Considerations for the Future

Kennedy, Joshua L.; Stoner, Ashley; Borish, Larry

doi:10.2500/ajra.2016.30.4370

Cited by 67 publications

(73 citation statements)

References 88 publications

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“…Aspirin and other NSAIDs may trigger severe airway obstruction in up to 10–15% of adults with asthma [53–55]; typically patients with severe and adult onset eosinophilic asthma and comorbid nasal polyposis, a condition termed Samter´s triad, aspirin-exacerbated respiratory disease (AERD) or Non-steroidal anti-inflammatory drugs-exacerbated respiratory disease (N-ERD) [56]. The intolerance is not an IgE mediated allergy and there is no in vitro test for diagnosis.…”

Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Section: Systematic Assessment Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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“…The prototype of the inflammatory endotype is represented by aspirinexacerbated respiratory disease (AERD). This condition is characterized by hypersensitivity to aspirin and other nonsteroidal antiinflammatory drugs leading to upper and lower airway inflammation, and resulting in severe rhinosinusitis and asthma symptoms [56]. Inhibition of cyclooxygenase-1 shifts the metabolism of arachidonic acid to the lipooxygenase pathway, resulting in increased cysteinyl leukotriene release precipitating local inflammation.…”

Section: Drug-induced Rhinitismentioning

confidence: 99%

“…The diagnosis of NAR is based on a detailed medical history and exclusion of clinically relevant sensitization to airborne allergens, and exclusion of clinical signs of rhinosinusitis. In the absence of atopy and negative SPT, increased nasal eosinophil counts and higher baseline levels of urinary LTE 4 would be considered a specific biomarker for AERD [56].…”

Section: Drug-induced Rhinitismentioning

confidence: 99%

A Precision Medicine Approach to Rhinitis Evaluation and Management

Crisci

Ardusso

2020

Curr Treat Options Allergy

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Purpose of Review Precision medicine (PM) represents a new paradigm in disease diagnosis, prevention, and treatment. The PM approach focuses on the characterization of different phenotypes and pathogenic pathways in order to allow the selection of specific biomarkers that will be useful in disease management. Rhinitis is a highly prevalent and heterogeneous disease, both in terms of underlying endotypes and clinical presentations. Therefore, to apply the PM principles to the various rhinitis subtypes rise as a meaningful strategy to improve evaluation and treatment. Recent Findings The technology of recombinant allergens has allowed molecular characterization of IgE reactivity of specific individual components of allergenic extracts. Recently published and ongoing clinical trials based on component resolved diagnosis (CRD) bring more precision to allergen immunotherapy for allergic rhinitis. Monoclonal antibodies against various cytokines involved in inflammatory allergic and nonallergic rhinitis endotypes show promissory results. Summary Better understanding of pathogenic pathways together with an accurate phenotype classification of patients presented with rhinitis symptoms contributes to point out clinical usefulness of biomarkers and other diagnostic tools, which leads to more accurate environmental control measures, personalized pharmacologic options, and new biological therapy developments.

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“…Such novel application methods may represent new alternatives to subcutaneous and sublingual immunotherapy in the future. In another systematic review, Kennedy et al 17 discussed the pathogenesis, risks-benefits of aspirin desensitization, and the role of surgical intervention in aspirin-exacerbated respiratory disease.…”

mentioning

confidence: 99%

Paradigm shifts in the medical and surgical management of rhinologic and allergic disease

Lee¹

2016

am j rhinol allergy

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Aspirin-Exacerbated Respiratory Disease: Prevalence, Diagnosis, Treatment, and Considerations for the Future

Abstract: Aspirin-exacerbated respiratory disease (AERD) is a late onset condition characterized by the

Cited by 67 publications

References 88 publications

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

A Precision Medicine Approach to Rhinitis Evaluation and Management

Paradigm shifts in the medical and surgical management of rhinologic and allergic disease

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