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Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper.
- Source :
-
Allergy [Allergy] 2019 Jan; Vol. 74 (1), pp. 28-39. Date of Electronic Publication: 2018 Oct 02. - Publication Year :
- 2019
-
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.<br /> (© 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
Details
- Language :
- English
- ISSN :
- 1398-9995
- Volume :
- 74
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Allergy
- Publication Type :
- Academic Journal
- Accession number :
- 30216468
- Full Text :
- https://doi.org/10.1111/all.13599