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
Hlavní autori:	Kowalski, Marek L., Agache, Ioana, Bavbek, Sevim, Bakirtas, Arzu, Blanca, Miguel, Bochenek, Grażyna, Bonini, Matteo, Heffler, Enrico, Klimek, Ludger, Laidlaw, Tanya M., Mullol, Joaquim, Niżankowska‐Mogilnicka, Ewa, Park, Hae‐Sim, Sanak, Marek, Sanchez‐Borges, Mario, Sanchez‐Garcia, Silvia, Scadding, Glenis, Taniguchi, Masami, Torres, Maria J., White, Andrew A., Wardzyńska, Aleksandra
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Denmark Blackwell Publishing Ltd 01.01.2019
Predmet:	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 asthma treatment AERD sinusitis ENT (rhinitis, sinusitis, nasal polyps…) asthma drug allergy
ISSN:	0105-4538, 1398-9995, 1398-9995
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Shrnutí:	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.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Instructional Material/Guideline-3 content type line 23
ISSN:	0105-4538 1398-9995 1398-9995
DOI:	10.1111/all.13599