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Clinical Features and Patient-Reported Control of Respiratory Tract and Ear Symptoms in NSAID-Exacerbated Respiratory Disease (N-ERD) - A Retrospective Cross-Sectional Questionnaire Study
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  • Anna Suikkila,
  • Lena Hafrén,
  • Annina Lyly,
  • tuomas klockars,
  • Riitta Saarinen
Anna Suikkila
Helsinki University Central Hospital Head and Neck Center
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Lena Hafrén
Helsinki University Central Hospital Head and Neck Center
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Annina Lyly
Helsinki University Central Hospital Head and Neck Center
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tuomas klockars
Helsinki University Central Hospital Head and Neck Center
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Riitta Saarinen
Helsinki University Central Hospital Head and Neck Center
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Abstract

ABSTRACT Objective We assessed the prevalence, clinical characteristics, and severity of respiratory tract and ear symptoms among Finnish Non-steroidal anti-inflammatory drug (NSAID) exacerbated respirato-ry disease (N-ERD) patients. Design A retrospective cross-sectional questionnaire study. Setting A university tertiary care center. Participants A total of 232 patients with both asthmatic and polypoid ICD-10 diagnoses treated at our universi-ty tertiary care center between January 2016 and May 2017 were identified by an electronic patient record search. The patient charts were manually reviewed and 102 patients with speci-fied symptoms on NSAID exposure, in addition to asthma and nasal polyposis diagnosis, were considered potential N-ERD patients. The patients received a questionnaire with an informed consent form, and the 66 patients who responded and confirmed diagnoses of asthma, nasal polyposis, and acetylsalicylic acid (ASA) or NSAID intolerance were included. Results The first diagnosis received was asthma, followed by NSAID intolerance and nasal polyposis, when evaluated by mean age of contracting the condition. When evaluating individual patients, there was considerable variation in the order and timing of the separate conditions. The majority of the patients received all three diagnoses within a few years’ time. The diagnostics and treat-ment of N-ERD patients seemed to only partially follow the international guidelines. The propor-tion of N-ERD patients with recurrent or chronic middle ear infection was 18%. Patient-reported disease control was good in asthma, but only mediocre in nasal polyposis and ear symptoms. As many as 14% reported a positive family history of N-ERD. Conclusions Structured cross-department diagnostics and care could benefit N-ERD patients in Finland. Rhi-nological and aural symptoms seem to affect a patient’s quality of life more than asthma. The high proportion of familial cases warrants further studies. Keywords: Asthma, Aspirin-Induced, Nasal Polyps, Aspirin, NSAIDs, Heredity, Ear, Middle, Fin-land