Aspirin-exacerbated respiratory disease increases asthma severity

There are more markers of severity, and striking differences in upper airway disease, among patients with aspirin-exacerbated respiratory disease (AARD) when compared to asthma in a heterogeneous, non-AERD patient population.

Researchers at the Scripps Clinic in San Diego, California, compared 100 AERD asthmatics with an equal number of matched non-AERD asthmatics. They found that unscheduled visits for asthma exacerbations were higher in the AERD group (0.53/year vs 0.18/year, P=0.009). The use of medications was the same for low- and medium-dose inhaled corticosteroids and use of bursts or continuous systemic corticosteroids. However, high-dose inhaled corticosteroids (33 vs 19, P=0.009), long acting bronchodilators (73 vs 46, P=0.003), and leukotriene receptor antagonists (77 vs 25, P<0.0001) were used more frequently in the AERD group. 

Further, abnormal sinus imaging results were characteristic of the AERD patients. Compared with the non-AERD group, they were pansinusitis (100 vs 10), any sinus opacification (100 vs 26), and nasal polyps (100 vs 7). History of any sinusitis was recorded in 100 AERD patients and 43 non-AERD patients. P values for all were P<0.0001.