NSAID-exacerbated respiratory disease: a population study

Heidi Andersén; Pinja Ilmarinen; Jasmin Honkamäki; Leena E Tuomisto; Hanna Hisinger-Mölkänen; Helena Backman; Bo Lundbäck; Eva Rönmark; Tari Haahtela; Anssi Sovijärvi; Lauri Lehtimäki; Päivi Piirilä; Hannu Kankaanranta

doi:10.1183/23120541.00462-2021

NSAID-exacerbated respiratory disease: a population study

Heidi Andersén, Pinja Ilmarinen, Jasmin Honkamäki, Leena E Tuomisto, Hanna Hisinger-Mölkänen, Helena Backman, Bo Lundbäck, Eva Rönmark, Tari Haahtela, Anssi Sovijärvi, Lauri Lehtimäki, Päivi Piirilä, Hannu Kankaanranta

Research output: Contribution to journal › Article › Scientific › peer-review

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.

Methods: In 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20-69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.

Results: The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.

Conclusion: We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.

Original language	English
Article number	00462-2021
Number of pages	10
Journal	Erj Open Research
Volume	8
DOIs	https://doi.org/10.1183/23120541.00462-2021
Publication status	Published - 2022
Publication type	A1 Journal article-refereed

Publication forum classification

Publication forum level 1

Access to Document

10.1183/23120541.00462-2021Licence: CC BY-NC

00462-2021.fullFinal published version, 619 KBLicence: CC BY-NC

https://urn.fi/URN:NBN:fi:tuni-202204294123Licence: CC BY-NC

Cite this

@article{0cb9f0eb118f4055bf5b59817af5109b,

title = "NSAID-exacerbated respiratory disease: a population study",

abstract = "Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.Methods: In 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20-69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.Results: The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.Conclusion: We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.",

author = "Heidi Anders{\'e}n and Pinja Ilmarinen and Jasmin Honkam{\"a}ki and Tuomisto, {Leena E} and Hanna Hisinger-M{\"o}lk{\"a}nen and Helena Backman and Bo Lundb{\"a}ck and Eva R{\"o}nmark and Tari Haahtela and Anssi Sovij{\"a}rvi and Lauri Lehtim{\"a}ki and P{\"a}ivi Piiril{\"a} and Hannu Kankaanranta",

note = "Copyright {\textcopyright}The authors 2022.",

year = "2022",

doi = "10.1183/23120541.00462-2021",

language = "English",

volume = "8",

}

NSAID-exacerbated respiratory disease : a population study. / Andersén, Heidi ; Ilmarinen, Pinja; Honkamäki, Jasmin; Tuomisto, Leena E; Hisinger-Mölkänen, Hanna; Backman, Helena; Lundbäck, Bo; Rönmark, Eva; Haahtela, Tari; Sovijärvi, Anssi; Lehtimäki, Lauri; Piirilä, Päivi; Kankaanranta, Hannu.

In: Erj Open Research, Vol. 8, 00462-2021, 2022.

Research output: Contribution to journal › Article › Scientific › peer-review

TY - JOUR

T1 - NSAID-exacerbated respiratory disease

T2 - a population study

AU - Andersén, Heidi

AU - Ilmarinen, Pinja

AU - Honkamäki, Jasmin

AU - Tuomisto, Leena E

AU - Hisinger-Mölkänen, Hanna

AU - Backman, Helena

AU - Lundbäck, Bo

AU - Rönmark, Eva

AU - Haahtela, Tari

AU - Sovijärvi, Anssi

AU - Lehtimäki, Lauri

AU - Piirilä, Päivi

AU - Kankaanranta, Hannu

PY - 2022

Y1 - 2022

N2 - Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.Methods: In 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20-69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.Results: The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.Conclusion: We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.

AB - Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.Methods: In 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20-69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.Results: The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.Conclusion: We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.

U2 - 10.1183/23120541.00462-2021

DO - 10.1183/23120541.00462-2021

M3 - Article

C2 - 35083326

VL - 8

M1 - 00462-2021

ER -

NSAID-exacerbated respiratory disease: a population study

Abstract

Publication forum classification

Access to Document

Fingerprint

Cite this