PT  - JOURNAL ARTICLE
AU  - Heidi Andersén
AU  - Pinja Ilmarinen
AU  - Jasmin Honkamäki
AU  - Leena E. Tuomisto
AU  - Hanna Hisinger-Mölkänen
AU  - Helena Backman
AU  - Bo Lundbäck
AU  - Eva Rönmark
AU  - Tari Haahtela
AU  - Anssi Sovijärvi
AU  - Lauri Lehtimäki
AU  - Päivi Piirilä
AU  - Hannu Kankaanranta
TI  - NSAID-exacerbated respiratory disease: a population study
AID  - 10.1183/23120541.00462-2021
DP  - 2022 Jan 01
TA  - ERJ Open Research
PG  - 00462-2021
VI  - 8
IP  - 1
4099  - http://openres.ersjournals.com/content/8/1/00462-2021.short
4100  - http://openres.ersjournals.com/content/8/1/00462-2021.full
SO  - erjor2022 Jan 01; 8
AB  - Background Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate respiratory symptoms. A recent European Academy of Allergy and Clinical Immunology position paper recommended the use of an acronym, N-ERD (NSAID-exacerbated respiratory disease), for this hypersensitivity associated with asthma or chronic rhinosinusitis with or without nasal polyposis. Our aim was to estimate the prevalence of N-ERD and identify factors associated with N-ERD.Methods In 2016, a cross-sectional questionnaire survey of a random adult population of 16 000 subjects aged 20–69 years was performed in Helsinki and Western Finland. The response rate was 51.5%.Results The prevalence was 1.4% for N-ERD, and 0.7% for aspirin-exacerbated respiratory disease (AERD). The prevalence of N-ERD was 6.9% among subjects with asthma and 2.7% among subjects with rhinitis. The risk factors for N-ERD were older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. Asthmatic subjects with N-ERD had a higher risk of respiratory symptoms, severe hypersensitivity reactions and hospitalisations than asthmatic subjects without N-ERD. The subphenotype of N-ERD with asthma was most symptomatic. Subjects with rhinitis associated with N-ERD, which would not be included in AERD, had the fewest symptoms.Conclusion We conclude that the prevalence of N-ERD was 1.4% in a representative Finnish adult population sample. Older age, family history of asthma or allergic rhinitis, cumulative exposure to tobacco smoke, secondhand smoke, and occupational exposures increased odds of N-ERD. N-ERD was associated with significant morbidity.Population-based prevalence of N-ERD is 1.4%. N-ERD is symptomatic, with a rhinitis subgroup. The risk factors for N-ERD are older age, family history of asthma or allergic rhinitis, long-term smoking and exposure to environmental pollutants. https://bit.ly/3HxGftP