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Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature.
J Allergy Clin Immunol. 2015 Mar; 135(3):676-81.e1.JA

Abstract

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.

Authors+Show Affiliations

Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif. Electronic address: jessicarajan@gmail.com.Scripps Translational Science Institute, San Diego, Calif.Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

25282015

Citation

Rajan, Jessica P., et al. "Prevalence of Aspirin-exacerbated Respiratory Disease Among Asthmatic Patients: a Meta-analysis of the Literature." The Journal of Allergy and Clinical Immunology, vol. 135, no. 3, 2015, pp. 676-81.e1.
Rajan JP, Wineinger NE, Stevenson DD, et al. Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature. J Allergy Clin Immunol. 2015;135(3):676-81.e1.
Rajan, J. P., Wineinger, N. E., Stevenson, D. D., & White, A. A. (2015). Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature. The Journal of Allergy and Clinical Immunology, 135(3), 676-e1. https://doi.org/10.1016/j.jaci.2014.08.020
Rajan JP, et al. Prevalence of Aspirin-exacerbated Respiratory Disease Among Asthmatic Patients: a Meta-analysis of the Literature. J Allergy Clin Immunol. 2015;135(3):676-81.e1. PubMed PMID: 25282015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature. AU - Rajan,Jessica P, AU - Wineinger,Nathan E, AU - Stevenson,Donald D, AU - White,Andrew A, Y1 - 2014/10/03/ PY - 2014/06/04/received PY - 2014/07/23/revised PY - 2014/08/14/accepted PY - 2014/10/6/entrez PY - 2014/10/6/pubmed PY - 2015/5/1/medline KW - Aspirin-exacerbated respiratory disease KW - Samter triad KW - aspirin-induced asthma KW - prevalence SP - 676 EP - 81.e1 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 135 IS - 3 N2 - 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. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/25282015/Prevalence_of_aspirin_exacerbated_respiratory_disease_among_asthmatic_patients:_A_meta_analysis_of_the_literature_ DB - PRIME DP - Unbound Medicine ER -