Abstract
Non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) is a chronic medical condition that includes asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to aspirin and other NSAIDs. Eosinophilic inflammation in the upper and lower airways is treated with local corticosteroids, repeated antibiotics, oral corticosteroid courses, endoscopic sinus surgery, and in some cases aspirin treatment after desensitization (ATAD). Nevertheless, the disease may be uncontrolled and it has a great impact on quality of life. A better understanding of the pathomechanisms of the disease and the development of medications that target type 2 inflammation mediators may have a crucial role in achieving better disease control in patients with N-ERD.
Highlights
Non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD), known as aspirin-exacerbated respiratory disease (AERD) or Samter’s triad, is a chronic eosinophilic inflammatory disorder that is defined as hypersensitivity to NSAIDs together with asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP)
N-ERD should be suspected if a patient with CRSwNP and asthma, reports upper or lower respiratory symptoms that occur after the intake of NSAIDs
Patients with N-ERD have an overproduction of cysteinyl leukotrienes and it seems that the leukotriene-modifying drugs (LTMD), Montelukast or Zileuton, could be a rational treatment of choice for patients with N-ERD
Summary
Management in the Treatment of NSAID-Exacerbated Respiratory Disease. Non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) is a chronic medical condition that includes asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to aspirin and other NSAIDs. Eosinophilic inflammation in the upper and lower airways is treated with local corticosteroids, repeated antibiotics, oral corticosteroid courses, endoscopic sinus surgery, and in some cases aspirin treatment after desensitization (ATAD). The disease may be uncontrolled and it has a great impact on quality of life. A better understanding of the pathomechanisms of the disease and the development of medications that target type 2 inflammation mediators may have a crucial role in achieving better disease control in patients with N-ERD
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