Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease

Whitney Stevens*, Anju Tripathi Peters, Annemarie G. Hirsch, Cara M. Nordberg, Brian S. Schwartz, Dione G. Mercer, Mahboobeh Mahdavinia, Leslie C Grammer III, Kathryn E Hulse, Robert C Kern, Pedro Avila, Robert P Schleimer

*Corresponding author for this work

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. Objective To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. Methods Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. Results The prevalence of AERD among patients with CRSwNP was 16%. Patients with AERD had undergone 2-fold more sinus surgeries (P <.001) and were significantly younger at the time of their first surgery (40 ± 13 years) than were patients with CRSwNP (43 ± 14 years; P <.05). Atopy was significantly more prevalent in patients with AERD (84%) or asthma (85%) than in patients with CRSwNP (66%, P <.05). More patients with AERD (13%) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4%, P <.01) or asthma (1%, P <.001). Conclusions AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors.

Original languageEnglish (US)
Pages (from-to)1061-1070.e3
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume5
Issue number4
DOIs
StatePublished - Jul 1 2017

Fingerprint

Aspirin
Nasal Polyps
Cyclooxygenase 1
Asthma
Asthma and Nasal Polyps
Cyclooxygenase Inhibitors
Electronic Health Records
Tertiary Healthcare
Adrenal Cortex Hormones
Chronic Disease
Demography

Keywords

  • AERD
  • Asthma
  • CRS
  • CRSwNP
  • Samter's disease
  • Sinus

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

@article{e63dadada6ac47828aa70feb015f9e05,
title = "Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease",
abstract = "Background Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. Objective To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. Methods Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. Results The prevalence of AERD among patients with CRSwNP was 16{\%}. Patients with AERD had undergone 2-fold more sinus surgeries (P <.001) and were significantly younger at the time of their first surgery (40 ± 13 years) than were patients with CRSwNP (43 ± 14 years; P <.05). Atopy was significantly more prevalent in patients with AERD (84{\%}) or asthma (85{\%}) than in patients with CRSwNP (66{\%}, P <.05). More patients with AERD (13{\%}) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4{\%}, P <.01) or asthma (1{\%}, P <.001). Conclusions AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors.",
keywords = "AERD, Asthma, CRS, CRSwNP, Samter's disease, Sinus",
author = "Whitney Stevens and Peters, {Anju Tripathi} and Hirsch, {Annemarie G.} and Nordberg, {Cara M.} and Schwartz, {Brian S.} and Mercer, {Dione G.} and Mahboobeh Mahdavinia and {Grammer III}, {Leslie C} and Hulse, {Kathryn E} and Kern, {Robert C} and Pedro Avila and Schleimer, {Robert P}",
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Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease. / Stevens, Whitney; Peters, Anju Tripathi; Hirsch, Annemarie G.; Nordberg, Cara M.; Schwartz, Brian S.; Mercer, Dione G.; Mahdavinia, Mahboobeh; Grammer III, Leslie C; Hulse, Kathryn E; Kern, Robert C; Avila, Pedro; Schleimer, Robert P.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 5, No. 4, 01.07.2017, p. 1061-1070.e3.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical Characteristics of Patients with Chronic Rhinosinusitis with Nasal Polyps, Asthma, and Aspirin-Exacerbated Respiratory Disease

AU - Stevens, Whitney

AU - Peters, Anju Tripathi

AU - Hirsch, Annemarie G.

AU - Nordberg, Cara M.

AU - Schwartz, Brian S.

AU - Mercer, Dione G.

AU - Mahdavinia, Mahboobeh

AU - Grammer III, Leslie C

AU - Hulse, Kathryn E

AU - Kern, Robert C

AU - Avila, Pedro

AU - Schleimer, Robert P

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. Objective To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. Methods Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. Results The prevalence of AERD among patients with CRSwNP was 16%. Patients with AERD had undergone 2-fold more sinus surgeries (P <.001) and were significantly younger at the time of their first surgery (40 ± 13 years) than were patients with CRSwNP (43 ± 14 years; P <.05). Atopy was significantly more prevalent in patients with AERD (84%) or asthma (85%) than in patients with CRSwNP (66%, P <.05). More patients with AERD (13%) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4%, P <.01) or asthma (1%, P <.001). Conclusions AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors.

AB - Background Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. Objective To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone. Methods Electronic medical records of patients at Northwestern in Chicago, Illinois, were searched by computer algorithm and then manual chart review to identify 459 patients with CRSwNP alone, 412 with both CRSwNP and asthma, 171 with AERD, and 300 with asthma only. Demographic and clinical features including sex, atopy, and sinus disease severity were characterized. Results The prevalence of AERD among patients with CRSwNP was 16%. Patients with AERD had undergone 2-fold more sinus surgeries (P <.001) and were significantly younger at the time of their first surgery (40 ± 13 years) than were patients with CRSwNP (43 ± 14 years; P <.05). Atopy was significantly more prevalent in patients with AERD (84%) or asthma (85%) than in patients with CRSwNP (66%, P <.05). More patients with AERD (13%) had corticosteroid-dependent disease than patients with both CRSwNP and asthma (4%, P <.01) or asthma (1%, P <.001). Conclusions AERD is common among patients with CRSwNP; even though patients with AERD have CRSwNP and asthma, the clinical course of their disease is not the same as of patients who have CRSwNP and asthma but are tolerant to COX-1 inhibitors.

KW - AERD

KW - Asthma

KW - CRS

KW - CRSwNP

KW - Samter's disease

KW - Sinus

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U2 - 10.1016/j.jaip.2016.12.027

DO - 10.1016/j.jaip.2016.12.027

M3 - Article

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JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

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