WHAT IS ASPIRIN EXACERBATED RESPIRATORY DISEASE (AERD)?
Aspirin Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad, is a chronic disease comprised of three clinical conditions: Asthma, Chronic Sinusitis with recurrent nasal polyps and sensitivity to COX-1 inhibitors like aspirin, ibuprofen and naproxen, among others.
WHAT ARE THE SYMPTOMS?
Onset occurs between the ages of 20 and 50 and is characterized by a sudden respiratory reaction that occurs after taking aspirin or aspirin-like medications. Those with Asthma are at a high risk of acquiring AERD, and those with both Asthma and Chronic Sinusitis with nasal polyps are at an even higher risk. Symptoms include nasal congestion, red and watery eyes, headache, sinus pain, sneezing, coughing, wheezing and chest tightness. If nasal polyps are present, you may lose your sense of smell.
HOW IS IT DIAGNOSED?
If you have been diagnosed with Asthma, nasal polyps with Chronic Sinusitis and respiratory reactions to aspirin and aspirin-like medications, you have AERD. If it is not clear if a respiratory reaction to aspirin exists, it may be necessary to do an aspirin challenge to confirm the diagnosis. This would be performed in a controlled setting with your Gateway Asthma & Allergy Relief doctor and other team members equipped to handle a severe reaction should one occur.
WHAT ARE THE TREATMENT OPTIONS?
Those diagnosed with AERD should avoid all medications classified as COX-1 inhibitors. (Acetaminophen is not a COX-1 inhibitor and can still be taken at low doses if an anti-inflammatory is needed.) Most patients will need daily inhaled corticosteroids to control the symptoms of Asthma. Nasal polyps may require steroid injections into the polyps or surgical removal if breathing becomes difficult. Aspirin desensitization may be needed to avoid the continual use of steroids. This involves the gradual administration of increasing doses of aspirin in a controlled setting. If successful, the patient can begin daily aspirin therapy, which has been shown to reduce the regrowth of nasal polyps and eliminate the need for steroid treatment.