Management of Non-steroidal Anti-inflammatory Drug-exacerbated Respiratory Disease.

Aspirin-exacerbated respiratory disease (AERD) is characterized by the clinical triad of asthma, nasal polyposis and sensitivity to aspirin and other non-steroidal anti-inflammatory drugs. Across the spectrum of chronic rhinosinusitis, patients with AERD are among those with the most severe sinopulmonary inflammation, often refractory to standard treatments. Although AERD has a reputation as a recalcitrant disease, presentation and response to treatment is often along a spectrum. Yet, there have recently been significant advances in the management of both asthma and nasal polyposis, allowing for new treatment options and a shift in standard management algorithms. This article explores the prevalence and workup of AERD and reviews the latest evidence in both medical and surgical management. Furthermore, the results of on-going clinical trials are eagerly awaited. With a growing assortment of treatment options, especially with the addition of biologics to the clinician's armamentarium, it is paramount to individualize therapy alongside a stepwise algorithm for what is considered a difficult-to-treat disease. [ABSTRACT FROM AUTHOR]