Asthma and lower airway diseasePrevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature
Section snippets
Data sources and searches
A systematic review of PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases was performed by using a prespecified protocol (Table I) and search strategy to identify all clinical trials published on or before June 16, 2013, that evaluated the prevalence of AERD (see Fig E1 in this article's Online Repository at www.jacionline.org). Additionally, manual searches were performed from reference lists of included studies to identify additional trials. Studies were
Study characteristics
After database search and removal of duplicates, a total of 159 articles were identified for full-text review (Fig 1). These were assessed on the basis of inclusion/exclusion criteria, and a manual search was performed on all references of chosen studies, resulting in a total of 27 studies; the characteristics of these studies are listed in Table II.1, 2, 3, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 Of those in which oral challenges were
Discussion
AERD is a complex disease process that requires clinician intuition to suspect the diagnosis. Patients with AERD typically have adult-onset asthma, nasal polyposis, chronic rhinosinusitis, and NSAID sensitivity. It is only on specifically querying reactions to other NSAIDS or aspirin that a provisional diagnosis can be rendered. Yet history is not enough, and 15% of patients with AERD might not be aware of their diagnosis before undergoing aspirin provocation challenges.33 It has also been
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Supported by the Scripps Clinic.
Disclosure of potential conflict of interest: J. P. Rajan is employed by Scripps Clinic, which funded this study. D. D. Stevenson has received consultancy fees from the Rease Steahly Clinic, support for travel or other study-related purposes from the Scripps Clinic, and payment for editing the Immunology and Allergy Clinics of North American issue on aspirin and nonsteroidal anti-inflammatory drugs. A. A. White is employed by Scripps Clinic and has received or has funding pending through an SCMG Education and Research Grant #8194. N. E. Wineinger was supported, in part, by NIH grant UL1TR001114.