Multiple risk factors for nonsteroidal anti-inflammatory drugs (NSAIDs) exacerbating respiratory disease with asthma

Key points:

• Univariate logistic regression analysis found that 23 covariates were associated with NERD in asthma patients.
• Being overweight was the only factor associated with a reduced risk of NERD.

Multiple risk factors are associated with respiratory illness exacerbated by nonsteroidal anti-inflammatory drugs (NSAIDs), which itself is associated with uncontrolled or severe asthma, according to a study published in the American Journal of Medicine. Clinical and Transformed Allergy.

Early identification of these risk factors may help control disease burden, soul haleifarrive, write research assistants and colleagues at the Department of Allergy, University Hospital Helsinki and Dermatology and Allergy Hospital Helsinki.

The study used data from the Finnish Adult Asthma Population-Matched Case-Control Study, which was conducted in 1996 and 1997 among 1,350 asthmatic adults (62.1% female) aged 30 years and older (mean age 54.39 years). ).

The cohort included 153 patients (11.3%; mean age 54.15 years; 18.3% male) with NSAID-exacerbated respiratory disease (NERD). Additionally, 11.2% of the full cohort and 19% of the NERD group had severe asthma.

Unadjusted analyzes found statistically significant associations (ask < .05) between asthma with NERD and 23 factors (such as being female); Being overweight; Allergic respiratory symptoms; Several cases of sinusitis and bronchitis diagnosed by a doctor in the last year; Nasal polyps; Ever smoking in the home and exposure to secondhand cigarette smoke; and atopic dermatitis, rhinitis, and rhinoconjunctivitis.

Multivariable regression models found significant associations compared with asthma without the NERD phenotype (ask < .05) Asthma with NERD is associated with:

• female (OR = 2.5; 95% CI, 1.52-4.09);
• overweight (OR = 0.65; 95% CI, 0.45-0.94);
• allergic respiratory symptoms (OR = 1.91; 95% CI, 1.21-3.02);
• self-reported difficult asthma (OR = 2.21; 95% CI, 1.28-3.82);
• nasal polyps (OR = 1.76; 95% CI, 1.07-2.9);
• exposure to secondhand tobacco smoke at home (OR = 2.38; 95% CI, 1.18-4.79);
• three or more siblings (OR = 1.63; 95% CI, 1.10-2.41); and
• Osteoarthritis (OR = 1.9; 95% CI, 1.23-2.95).

The researchers further divided the cohort into Group 1, which included 667 young patients (aged 31-54 years) born between 1943 and 1966, 80 of whom had NERD; Group 2, which included 683 patients born in 1904 to elderly patients (aged 55-93 years) born between 1942, 73 of whom had NERD.

In Group 1, multivariate analysis found that self-reported difficult asthma (OR = 3.11; 95% CI, 1.47-6.57) and nasal polyps (OR = 1.99; 95% CI, 1.03-3.84) were significantly associated with NERD Related. High BMI also showed a trend toward lower risk of NERD in this group (OR = 0.65; 95% CI, 0.39-1.08).

Group 2 showed NERD associated with female gender (OR = 4.29; 95% CI, 1.99-9.25), allergic respiratory symptoms (OR = 2.22; 95% CI, 1.14-4.3), and osteoarthritis (OR = 2.04; 95% Significant correlations between CI, 1.14-4.3), 1.2-3.47), also in multivariate analyses.

Additionally, multivariate analysis found that NERD was associated with uncontrolled asthma and allergic respiratory symptoms (OR = 2.75; 95% CI, 1.21-6.23) and self-reported difficult asthma (OR = 4.44; 95% CI, 1.63-12.11 ) There is a significant correlation between.

In patients without NERD, there was a significant association between uncontrolled asthma and:

• female (OR = 0.55; 95% CI, 0.42-0.72);
• Age at onset of asthma was 40 years and older (OR = 1.92; 95% CI, 1.4-2.63);
• allergic respiratory symptoms (OR = 1.3; 95% CI, 1-1.69);
• having several doctor-diagnosed bronchitis in the past year (OR = 1.56; 95% CI, 1.11-2.2);
• self-reported difficult asthma (OR = 5.08; 95% CI, 3.01-8.59);
• regular or in-course use of oral corticosteroids (OR = 1.93; 95% CI, 1.44-2.59);
• recurrent respiratory tract infections in adulthood (OR = 1.49; 95% CI, 1.14-1.96);
• back disease (OR = 1.38; 95% CI, 1.03-1.84); and
• Physician-diagnosed pneumonia in the past year (OR = 2.62; 95% CI, 1.04-6.58).

Overall, the researchers concluded that female sex, allergic respiratory symptoms, difficult asthma, nasal polyps, household secondhand smoke exposure, three or more siblings, and osteoarthritis independently increased the risk of NERD asthma, whereas Being overweight reduces this risk.

These factors reinforce the need for smoking cessation in the living environment of NERD patients and the importance of early detection and management of these risk factors to prevent severe adult-onset asthma in these patients, the researchers wrote.