Diagnosis and management of NSAID‐Exacerbated Respiratory Disease (N‐ERD)—a EAACI position paper

• DOI: 10.1111/all.13599
• Publication Date: 2018-09-16T07:57:30Z
• Authors: Marek L. Kowalski; Ioana Agache; Sevim Bavbek; Arzu Bakirtas; Miguel Blanca; Grażyna Bochenek; Matteo Bonini; Enrico Heffler; Ludger Klimek; Tanya M. Laidlaw; Joaquim Mullol; Ewa Niżankowska‐M...; Hae‐Sim Park; Marek Sanak; Mario Sanchez‐Borges; Silvia Sanchez‐Ga...; Glenis Scadding; Masami Taniguchi; Maria J. Torres; Andrew A. White; Aleksandra Wardzy...
• Keywords: Nasal Polyps; Chronic Rhinosinusitis; Position paper; Pathophysiology

NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the tract occurring in patients with asthma and/or rhinosinusitis nasal polyps (CRSwNP), symptoms which are exacerbated by NSAIDs, including aspirin. Despite some progress understanding pathophysiology syndrome, affects 1/10 and rhinosinusitis, it remains diagnostic therapeutic challenge. In order to provide evidence-based recommendations for diagnosis management N-ERD, panel international experts was called EAACI Asthma Section. The document summarizes current knowledge on clinical presentation N-ERD pointing at significant heterogeneity this syndrome. Critically evaluating usefulness tools available, paper offers practical algorithm N-ERD. Recommendations most effective patient stressing potential high morbidity severity underlying discussed proposed. Newly described sub-phenotypes emerging sub-endotypes potentially relevant new more specific (eg, biological) treatment modalities. Finally, defines major gaps our unmet needs, should be addressed future.