Clinical Features and Patient-Reported Control of Respiratory Tract and
Ear Symptoms in NSAID-Exacerbated Respiratory Disease (N-ERD) - A
Retrospective Cross-Sectional Questionnaire Study
Abstract
ABSTRACT Objective We assessed the prevalence, clinical characteristics,
and severity of respiratory tract and ear symptoms among Finnish
Non-steroidal anti-inflammatory drug (NSAID) exacerbated respirato-ry
disease (N-ERD) patients. Design A retrospective cross-sectional
questionnaire study. Setting A university tertiary care center.
Participants A total of 232 patients with both asthmatic and polypoid
ICD-10 diagnoses treated at our universi-ty tertiary care center between
January 2016 and May 2017 were identified by an electronic patient
record search. The patient charts were manually reviewed and 102
patients with speci-fied symptoms on NSAID exposure, in addition to
asthma and nasal polyposis diagnosis, were considered potential N-ERD
patients. The patients received a questionnaire with an informed consent
form, and the 66 patients who responded and confirmed diagnoses of
asthma, nasal polyposis, and acetylsalicylic acid (ASA) or NSAID
intolerance were included. Results The first diagnosis received was
asthma, followed by NSAID intolerance and nasal polyposis, when
evaluated by mean age of contracting the condition. When evaluating
individual patients, there was considerable variation in the order and
timing of the separate conditions. The majority of the patients received
all three diagnoses within a few years’ time. The diagnostics and
treat-ment of N-ERD patients seemed to only partially follow the
international guidelines. The propor-tion of N-ERD patients with
recurrent or chronic middle ear infection was 18%. Patient-reported
disease control was good in asthma, but only mediocre in nasal polyposis
and ear symptoms. As many as 14% reported a positive family history of
N-ERD. Conclusions Structured cross-department diagnostics and care
could benefit N-ERD patients in Finland. Rhi-nological and aural
symptoms seem to affect a patient’s quality of life more than asthma.
The high proportion of familial cases warrants further studies.
Keywords: Asthma, Aspirin-Induced, Nasal Polyps, Aspirin, NSAIDs,
Heredity, Ear, Middle, Fin-land