NSAID-ERD Syndrome: the New Hope from Prevention, Early Diagnosis, and New Therapeutic Targets

Curr Allergy Asthma Rep. 2020 Mar 14;20(4):10. doi: 10.1007/s11882-020-00905-9.

Abstract

Purpose of review: This review summarizes the latest information on the appropriate identification, evaluation, and treatment of patients with nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NSAID-ERD), also known as aspirin-exacerbated respiratory disease (AERD). Within the framework of our understanding of the underlying pathophysiology of NSAID-ERD, we also provide an update regarding new surgical techniques and newly available or upcoming medical therapies that may benefit these patients.

Recent findings: There have been considerable developments regarding recommendations for both the extent and timing of sinus surgery for NSAID-ERD. The last few years have also given us several new biologic medications that warrant consideration in the treatment of patients with recalcitrant NSAID-ERD. Further clinical trials are underway to investigate additional medications that may decrease the type 2 inflammation that dominates this disease. Despite the severe lower respiratory inflammation and recurrent nature of the nasal polyps in patients with NSAID-ERD, significant recent advances now afford much-improved quality of life for these patients. Careful collaboration between Allergy/Immunology and Rhinology specialists is imperative to ensure proper treatment of patients with NSAID-ERD.

Keywords: AERD; Aspirin; Asthma; NSAID-ERD; NSAIDs; Nasal polyps.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Aspirin / adverse effects*
  • Asthma, Aspirin-Induced* / diagnosis
  • Asthma, Aspirin-Induced* / prevention & control
  • Asthma, Aspirin-Induced* / surgery
  • Early Diagnosis
  • Humans
  • Nasal Surgical Procedures
  • Quality of Life / psychology
  • Rhinitis, Allergic* / chemically induced
  • Rhinitis, Allergic* / diagnosis
  • Rhinitis, Allergic* / prevention & control
  • Rhinitis, Allergic* / surgery
  • Syndrome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin