Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Curr Allergy Asthma Rep. 2020 Mar 14;20(4):10. doi: 10.1007/s11882-020-00905-9.
This review summarizes the latest information on the appropriate identification, evaluation, and treatment of patients with nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NSAID-ERD), also known as aspirin-exacerbated respiratory disease (AERD). Within the framework of our understanding of the underlying pathophysiology of NSAID-ERD, we also provide an update regarding new surgical techniques and newly available or upcoming medical therapies that may benefit these patients.
There have been considerable developments regarding recommendations for both the extent and timing of sinus surgery for NSAID-ERD. The last few years have also given us several new biologic medications that warrant consideration in the treatment of patients with recalcitrant NSAID-ERD. Further clinical trials are underway to investigate additional medications that may decrease the type 2 inflammation that dominates this disease. Despite the severe lower respiratory inflammation and recurrent nature of the nasal polyps in patients with NSAID-ERD, significant recent advances now afford much-improved quality of life for these patients. Careful collaboration between Allergy/Immunology and Rhinology specialists is imperative to ensure proper treatment of patients with NSAID-ERD.
本文总结了非甾体抗炎药(NSAID)加重的呼吸系统疾病(NSAID-ERD),又称阿司匹林加重的呼吸系统疾病(AERD)患者的恰当识别、评估和治疗的最新信息。在我们对 NSAID-ERD 潜在病理生理学的理解框架内,我们还提供了有关新手术技术以及新出现或即将出现的可能使这些患者受益的医学治疗方法的最新信息。
NSAID-ERD 患者鼻窦手术的范围和时间均有相当大的进展。过去几年,我们还获得了几种新的生物药物,这些药物在治疗顽固的 NSAID-ERD 患者时值得考虑。正在进行进一步的临床试验,以研究可能减少主导这种疾病的 2 型炎症的其他药物。尽管 NSAID-ERD 患者的下呼吸道炎症严重且鼻息肉反复发作,但最近的显著进展现在为这些患者提供了大大改善的生活质量。过敏/免疫学和鼻科学专家之间的密切合作对于确保 NSAID-ERD 患者的正确治疗至关重要。