Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature - 05/03/15
, Nathan E. Wineinger, PhD b, Donald D. Stevenson, MD a, Andrew A. White, MD aAbstract |
Background |
Aspirin-exacerbated respiratory disease (AERD) is manifested by adult-onset asthma, nasal polyposis, chronic rhinosinusitis, and aspirin sensitivity. Previously reported prevalence rates have been widely variable based on the population studied, method of diagnosis, and definition of aspirin sensitivity.
Objective |
We sought to determine the prevalence of AERD among asthmatic adults.
Methods |
A systematic review of databases was performed to identify all clinical trials published on or before June 16, 2013, that evaluated the prevalence of AERD. The studies were clustered into 7 different groups based on underlying disease (asthma, nasal polyps or chronic rhinosinusitis, or both), as well as on the methodology of prevalence determination.
Results |
A total of 1770 articles were identified, with 27 considered appropriate for inclusion. Prevalence rates of AERD ranged from 5.5% to 12.4% based on study type. Among all studies in asthmatic patients, regardless of method, the prevalence of AERD was 7.15% (95% CI, 5.26% to 9.03%). The prevalence of AERD was highest among patients with severe asthma (14.89% [95% CI, 6.48% to 23.29%]). Among patients with nasal polyps and chronic rhinosinusitis, the prevalence was 9.69% (95% CI, 2.16% to 17.22%) and 8.7% (95% CI, −1.02% to 18.34%), respectively.
Conclusion |
AERD is a distinct and important subtype of asthma and polypoid sinus disease. The prevalence of AERD is 7% in typical adult asthmatic patients and twice that number in patients with severe asthma, which underscores the importance of recognizing this disorder. Early identification of this syndrome is critical in view of the increased morbidity and costs associated with asthma exacerbations and the option to treat patients with AERD with long-term aspirin treatment after desensitization.
Le texte complet de cet article est disponible en PDF.Key words : Aspirin-exacerbated respiratory disease, Samter triad, aspirin-induced asthma, prevalence
Abbreviations used : AERD, NSAID
Plan
| Supported by the Scripps Clinic. |
|
| Disclosure of potential conflict of interest: J. P. Rajan is employed by Scripps Clinic, which funded this study. D. D. Stevenson has received consultancy fees from the Rease Steahly Clinic, support for travel or other study-related purposes from the Scripps Clinic, and payment for editing the Immunology and Allergy Clinics of North American issue on aspirin and nonsteroidal anti-inflammatory drugs. A. A. White is employed by Scripps Clinic and has received or has funding pending through an SCMG Education and Research Grant #8194. N. E. Wineinger was supported, in part, by NIH grant UL1TR001114. |
Vol 135 - N° 3
P. 676 - mars 2015 Retour au numéro
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