An update on the management of aspirin-exacerbated respiratory disease

Authors
Ji-Ho LeeChang-Gyu JungHae-Sim Park
Department
Dept. of Internal Medicine (내과학)
Issue Date
2018
Citation
Expert Review of Respiratory Medicine, Vol.12(2) : 137-143, 2018
ISSN
1747-6348
Abstract
Clinical features of aspirin-exacerbated respiratory disease (AERD) consist of moderate to severe asthma associated with chronic rhinosinusitis (CRS), which are derived from overproduction of cysteinyl leukotrienes along with chronic type 2 mediated inflammation in the upper and lower airway mucosa. Area covered: This review provides recent up-to-date information regarding phenotypes of AERD and encompasses comprehensive diagnostic methods and treatment options. To confirm the diagnosis of AERD, provocation testing via nasal, inhalation or the oral route of aspirin remains the gold standard; in vitro diagnostic methods are still not available. Essential management is to avoid cross-reacting cyclooxygenase 1 (COX-1) inhibitors along with use of highly selective COX-2 inhibitors and to maintain pharmacologic treatment depending on the severity of asthma and chronic rhinosinusitis. Recent biologics, including anti-IgE and anti-IL5 antibodies, are required in severe AERD patients with CRS. Aspirin desensitization can be recommended when indicated. Expert commentary: AERD is a heterogeneous disease in terms of severity and associated allergic disease. When performing diagnosis and treatment for AERD, such disease characteristics need to be kept in mind.
Keywords
Aspirin-exacerbated respiratory diseaseleukotrienemanagementsevere asthmaprovocation test
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41064
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
정창규
Full Text
http://www.tandfonline.com/doi/full/10.1080/17476348.2018.1417843
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