Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)—a EAACI position paper

Marek L. Kowalski, Ioana Agache, Sevim Bavbek, Arzu Bakirtas, Miguel Blanca, Grażyna Bochenek, Matteo Bonini, Enrico Heffler, Ludger Klimek, Tanya M. Laidlaw, Joaquim Mullol, Ewa Niżankowska-Mogilnicka, Hae-Sim Park, Marek Sanak, Mario Sanchez-Borges, Silvia Sanchez-Garcia, Glenis Scadding, Masami Taniguchi, Maria J. Torres, Andrew A. WhiteAleksandra Wardzyńska

Risultato della ricerca: Contributo in rivistaArticolo in rivista

115 Citazioni (Scopus)


NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence-based recommendations for the diagnosis and management of N-ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N-ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N-ERD. Recommendations for the most effective management of a patient with N-ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub-phenotypes and emerging sub-endotypes of N-ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N-ERD and unmet needs, which should be addressed in the future.
Lingua originaleEnglish
pagine (da-a)28-39
Numero di pagine12
Stato di pubblicazionePubblicato - 2019


  • AERD
  • ENT (rhinitis, sinusitis, nasal polyps…)
  • Immunology
  • Immunology and Allergy
  • asthma
  • asthma treatment
  • drug allergy
  • sinusitis


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