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Aspirin-Exacerbated Respiratory Disease (AERD): Adults With Asthma Could Have It Without Knowing

The three main components of AERD are asthma, nasal polyps, and extreme sensitivity to aspirin and other NSAIDs. It affects 8-10% of adults with asthma and 25-30% of adults with both asthma and nasal polyps.

AERD is an extreme sensitivity to the most common pain relief medicines in the world known as NSAIDs. These include ibuprofen (Advil, Motrin, Nuprin), naproxen (Aleve), and aspirin (Anacin, Bayer, Bufferin). It’s estimated that more than 30 million people in the U.S. use these medicines to alleviate pain on a regular basis.

NSAIDs interfere with “housekeeping” enzymes (COX) that are responsible for reducing inflammation and pain. This interference results in decreased formation of anti-inflammatory compounds and the overproduction of potent pro-inflammatory leukotrienes.

When passing through the airways, leukotrienes trigger the inflammation and bronchial tubes’ swelling. The first adverse symptoms include nasal congestion, sneezing, and runny nose within an hour of taking NSAIDs.

Nonrespiratory symptoms are facial pressure and flushing, hives, nausea, abdominal pain, and vomiting. If left untreated, it could progress to asthma followed by the nasal polyps’ occurrence.

AERD is a relatively sudden disease. It develops over a period of several years with symptoms appearing slowly. It usually affects adults with a slightly higher risk of being developed in women.

However, the disease is still little-known and requires a specialist to diagnose it. Avoiding NSAIDs will not stop the progression of the disease.

AERD inflammation develops regardless of exposure to NSAIDs.

The treatment that has shown to be most effective for many patients is aspirin desensitization. Doses of aspirin are introduced to patients in a controlled setting to desensitize their system to the offender. Improvement may be noticeable after only a month of treatment.

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