The prevalence of aspirin exacerbated respiratory disease – more common than you think

Published Online: October 2, 2014

Aspirin exacerbated respiratory disease (AERD) is a disease that occurs in patients with nasal polyps and asthma. These patients will all have severe allergic reactions to aspirin or other similar non-steroidal anti-inflammatory drugs. AERD can only be accurately diagnosed by a challenge with aspirin in an observed medical setting. In the last three decades many studies have tried to determine how common AERD is. These studies used very different methods to determine whether a patient has AERD. This unfortunately led to such a wide variation in reports of how common AERD is in asthmatics (1-42%) that individual studies carried little weight.

In a study recently published in The Journal of Allergy and Clinical Immunology, Rajan et al examined all studies reported in the English language on the prevalence of AERD in asthmatics. Out of a total of 159 studies, 27 were done in a manner that allowed inclusion into this analysis. The studies were performed between 1968-2012 in various countries and regions around the world. Using statistical analysis, all the rates of reported AERD in asthmatics or in patients with nasal polyps were combined.

In the report from Rajan and colleagues at Scripps Clinic, approximately 5-7% of all asthmatics appear to have AERD. In patients with severe asthma, 15% have AERD (1 in 8 asthmatics). In those patients with nasal polyps, the rate of AERD was similar to asthmatics at 9%. When put in the context that 1 in 20 asthmatics have AERD, this is likely more common than most respiratory specialists would appreciate. Furthermore, in severe asthmatics, the rate of AERD is high enough that detailed questions regarding aspirin or NSAID intake should be garnered in every new consultation.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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