Prevalence of NSAID-ERD among Patients with Chronic Rhinosinusitis with Nasal Polyps in the Global AROMA Registry.

Abstract

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease associated with severe symptom burden and reduced quality of life. Non- steroidal anti inflammatory drug-exacerbated respiratory disease (NSAID-ERD) is a common coexisting condition, associated with more severe sinus disease and increased corticosteroid use.

Purpose: To describe baseline characteristics and disease burden in patients with CRSwNP with coexisting NSAID-ERD in the Global AROMA registry.

Methods: AROMA is a prospective global registry study recruiting adult patients with severe CRSwNP who initiate dupilumab and following them for up to 36 months. Baseline demographics and disease characteristics were assessed for all patients entering the registry.

Results: As of February 2023, the study had recruited 303 patients; 77 (25.4%) had coexisting NSAID ERD. Of these patients, 11 (14.3%) had undergone a confirmatory aspirin challenge and 11 (14.3%) had undergone an aspirin desensitization. The rate of previous sinonasal surgery was 64.9% in the coexisting NSAID-ERD group and 60.6% in the group without NSAID ERD. The mean (SD) loss of smell score in patients with coexisting NSAID-ERD was 2.4 (0.85) versus 2.1 (1.16) in patients without (p = 0.0085). Leukotriene receptor antagonist use at baseline was 45.5% in patients with coexisting NSAID-ERD and 29.2% in patients without.

Conclusions: One-quarter of adults with CRSwNP in AROMA have coexisting NSAID-ERD, and most have not undergone a confirmatory aspirin challenge or desensitization. Patients with CRSwNP with coexisting NSAID-ERD report more severe smell loss at baseline and are more likely to have undergone sinonasal surgery.