N-ERD in Hospital Pedro Hispano: A single center experience and state-of-the-art

Authors

  • Catarina Rato Serviço de Otorrinolaringologia do Hospital Pedro Hispano, Matosinhos, Portugal
  • Ana Isabel Gonçalves Serviço de Otorrinolaringologia do Hospital Pedro Hispano, Matosinhos, Portugal
  • Gustavo Lopes Serviço de Otorrinolaringologia do Hospital Pedro Hispano, Matosinhos, Portugal
  • Delfim Duarte Serviço de Otorrinolaringologia do Hospital Pedro Hispano, Matosinhos, Portugal
  • Sara Cruz Serviço de Otorrinolaringologia do Hospital Pedro Hispano, Matosinhos, Portugal

DOI:

https://doi.org/10.34631/sporl.831

Keywords:

Chronic rhinosinusitis, Nasal polyps, Asthma, Aspirin hypersensitivity

Abstract

Introduction: Many questions related to the natural history of NSAID (non-steroidal anti-inflammatory drugs)-exacerbated respiratory disease (N-ERD) remains unanswered.

Objectives: To know and to understand the timeline and course of N-ERD.

Material and Methods: Retrospective study, performed between 2014 and 2019, of N-ERD cases followed in one ENT department.

Results: Twenty-one patients were selected. The mean age at onset of symptoms was 36.67 years. Of the 3 entities that make up the N-ERD, asthma was the initial diagnosis in the majority (52.4%) of patients. The average interval between the diagnosis of airway disease and the recognition of hypersensitivity to NSAIDs was 3.95 years. Nine patients are medicated with montelukast and one patient with biological agents.

Conclusions: There is an urgent need to develop strategies to identify patients with N-ERD. Understanding the natural history of the disease is the first step in making the diagnosis more clear-sighted.

References

- Fokkens WJ, Lund VJ, Hopkins C, Hellings PW et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1-464

- Kowalski ML, Agache I, Bavbek S, Bakirtas A et al. Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper. Allergy. 2019;74(1):28-39

- Miller B, Mirakian R, Gane S, Larco J et al. Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease: asthma and rhinitis. Clin Exp Allergy. 2013;43(8):874-80

- Roland LT, Wang H, Mehta CC, Cahill KN et al. Longitudinal progression of aspirin-exacerbated respiratory disease: analysis of a national insurance claims database. Int Forum Allergy Rhinol. 2019;9(12):1420-1423

- Nabavi M, Esmaeilzadeh H, Arshi S, Bemanian MH et al. Aspirin hypersensitivity in patients with chronic rhinosinusitis and nasal polyposis: frequency and contributing factors. Am J Rhinol Allergy. 2014;28(3):239-43

– Lee Ru, Stevenson DD. Aspirin-exacerbated respiratory disease: evalution and management. Allergy Asthma Immuno Res. 2011;3:3-10

- Bavbek S, Dursun B, Dursun E, et al. The prevalence of aspirin hypersensitivity in patients with nasal polyposis and contributing factors. Am J Rhinol Allergy. 2011;25:411–415

- Fahrenholz JM. Natural history and clinical features of aspirinexacerbated respiratory disease. Clin Rev Allergy Immunol. 2003; 24:113.

- Szczeklik A, Nizankowska E, Duplaga M. Natural history of aspirininduced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma. Eur Respir J. 2000; 16:432.

- Bhattacharyya N. Assessing the additional disease burden of polyps in chronic rhinosinusitis. The Annals of otology, rhinology, and laryngology. 2009;118:185-9

- Gevaert P, Van Bruaene N, Cattaert T, Van Steen K, et al. Mepolizumab, a humanized anti-IL-5 mAb, as a treatment option for severe nasal polyposis. J Allergy Clin Immunol 2011;128:989-995.

- Bachert C, Sousa AR, Lund VJ, Scadding GK, et al. Reduced need for surgery in severe nasal polyposis with mepolizumab: Randomized trial. J Allergy Clin Immunol 2017;140:1024-1031.

- Laidlaw TM, Mullol J, Fan C, et al. Dupilumab improves nasal polyp burden and asthma control in patients with CRSwNP and AERD. J Allergy Clin Immunol Pract 2019; 7:2462.

- Ta V, White AA. Survey-Defined Patient Experiences with Aspirin-Exacerbated Respiratory Disease. J Allergy Clin Immunol Pract. 2015;3:711.

Published

2020-10-01

How to Cite

Rato, C., Gonçalves, A. I., Lopes, G., Duarte, D., & Cruz, S. (2020). N-ERD in Hospital Pedro Hispano: A single center experience and state-of-the-art. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 58(3), 115–119. https://doi.org/10.34631/sporl.831

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Section

Original Article