Diagnosis and management of NSAID‐Exacerbated Respiratory Disease (N‐ERD)—a EAACI position paper
NSAID‐exacerbated respiratory disease (N‐ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in...
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| Vydané v: | Allergy (Copenhagen) Ročník 74; číslo 1; s. 28 - 39 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
Denmark
Blackwell Publishing Ltd
01.01.2019
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| ISSN: | 0105-4538, 1398-9995, 1398-9995 |
| On-line prístup: | Získať plný text |
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| Abstract | NSAID‐exacerbated respiratory disease (N‐ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence‐based recommendations for the diagnosis and management of N‐ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N‐ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N‐ERD. Recommendations for the most effective management of a patient with N‐ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub‐phenotypes and emerging sub‐endotypes of N‐ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N‐ERD and unmet needs, which should be addressed in the future. |
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| AbstractList | NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence-based recommendations for the diagnosis and management of N-ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N-ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N-ERD. Recommendations for the most effective management of a patient with N-ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub-phenotypes and emerging sub-endotypes of N-ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N-ERD and unmet needs, which should be addressed in the future.NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence-based recommendations for the diagnosis and management of N-ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N-ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N-ERD. Recommendations for the most effective management of a patient with N-ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub-phenotypes and emerging sub-endotypes of N-ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N-ERD and unmet needs, which should be addressed in the future. NSAID‐exacerbated respiratory disease (N‐ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence‐based recommendations for the diagnosis and management of N‐ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N‐ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N‐ERD. Recommendations for the most effective management of a patient with N‐ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub‐phenotypes and emerging sub‐endotypes of N‐ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N‐ERD and unmet needs, which should be addressed in the future. NSAID ‐exacerbated respiratory disease (N‐ ERD ) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps ( CRS w NP ), symptoms of which are exacerbated by NSAID s, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence‐based recommendations for the diagnosis and management of N‐ ERD , a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N‐ ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N‐ ERD . Recommendations for the most effective management of a patient with N‐ ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub‐phenotypes and emerging sub‐endotypes of N‐ ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N‐ ERD and unmet needs, which should be addressed in the future. |
| Author | Sanchez‐Borges, Mario Wardzyńska, Aleksandra Heffler, Enrico Agache, Ioana Klimek, Ludger Sanchez‐Garcia, Silvia Bavbek, Sevim Park, Hae‐Sim Blanca, Miguel Mullol, Joaquim Laidlaw, Tanya M. Taniguchi, Masami Bochenek, Grażyna Sanak, Marek Scadding, Glenis Kowalski, Marek L. Bonini, Matteo Torres, Maria J. Bakirtas, Arzu White, Andrew A. Niżankowska‐Mogilnicka, Ewa |
| Author_xml | – sequence: 1 givenname: Marek L. orcidid: 0000-0002-8442-2774 surname: Kowalski fullname: Kowalski, Marek L. email: marek.kowalski@csk.umed.lodz.pl organization: Medical University – sequence: 2 givenname: Ioana orcidid: 0000-0001-7994-364X surname: Agache fullname: Agache, Ioana organization: Transylvania University – sequence: 3 givenname: Sevim surname: Bavbek fullname: Bavbek, Sevim organization: Ankara University – sequence: 4 givenname: Arzu surname: Bakirtas fullname: Bakirtas, Arzu organization: Gazi University – sequence: 5 givenname: Miguel surname: Blanca fullname: Blanca, Miguel organization: Allergy Service Hospital Infanta Leonor – sequence: 6 givenname: Grażyna surname: Bochenek fullname: Bochenek, Grażyna organization: Jagiellonian University Medical College – sequence: 7 givenname: Matteo surname: Bonini fullname: Bonini, Matteo organization: Royal Brompton Hospital & Imperial College London – sequence: 8 givenname: Enrico surname: Heffler fullname: Heffler, Enrico organization: Humanitas University – sequence: 9 givenname: Ludger surname: Klimek fullname: Klimek, Ludger organization: Center for Rhinology and Allergology – sequence: 10 givenname: Tanya M. surname: Laidlaw fullname: Laidlaw, Tanya M. organization: Harvard Medical School – sequence: 11 givenname: Joaquim orcidid: 0000-0003-3463-5007 surname: Mullol fullname: Mullol, Joaquim organization: IDIBAPS, and CIBERES – sequence: 12 givenname: Ewa surname: Niżankowska‐Mogilnicka fullname: Niżankowska‐Mogilnicka, Ewa organization: Jagiellonian University Medical College – sequence: 13 givenname: Hae‐Sim orcidid: 0000-0003-2614-0303 surname: Park fullname: Park, Hae‐Sim organization: Ajou University School of Medicine – sequence: 14 givenname: Marek orcidid: 0000-0001-7635-8103 surname: Sanak fullname: Sanak, Marek organization: Jagiellonian University Medical College – sequence: 15 givenname: Mario surname: Sanchez‐Borges fullname: Sanchez‐Borges, Mario organization: Centro Medico‐Docente La Trinidad – sequence: 16 givenname: Silvia surname: Sanchez‐Garcia fullname: Sanchez‐Garcia, Silvia organization: Hospital Infantil Universitario Niño Jesús – sequence: 17 givenname: Glenis surname: Scadding fullname: Scadding, Glenis organization: Royal National TNE Hospital – sequence: 18 givenname: Masami surname: Taniguchi fullname: Taniguchi, Masami organization: Sagamihara National Hospital – sequence: 19 givenname: Maria J. orcidid: 0000-0001-5228-471X surname: Torres fullname: Torres, Maria J. organization: ARADyAL – sequence: 20 givenname: Andrew A. surname: White fullname: White, Andrew A. organization: Scripps Clinic – sequence: 21 givenname: Aleksandra surname: Wardzyńska fullname: Wardzyńska, Aleksandra organization: Medical University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30216468$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | AERD Algorithms Anti-Inflammatory Agents, Non-Steroidal - adverse effects Aspirin Asthma asthma treatment Asthma, Aspirin-Induced - diagnosis Diagnosis Disease Management drug allergy ENT (rhinitis, sinusitis, nasal polyps…) Humans Inflammatory diseases Leukocytes (eosinophilic) Management Medical diagnosis Morbidity Nonsteroidal anti-inflammatory drugs Pathophysiology Patients Phenotypes Polyps Respiratory diseases Respiratory tract Respiratory Tract Diseases - chemically induced Rhinitis Rhinosinusitis Sinusitis |
| Title | Diagnosis and management of NSAID‐Exacerbated Respiratory Disease (N‐ERD)—a EAACI position paper |
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