Certain Clinical Markers May Predict AERD in Patients With CRSwNP

Clinical markers correlated with aspirin-exacerbated respiratory disease (AERD) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) include serum eosinophils (EOS), spot urine leukotriene E4 (LTE4), and Lund-Mackay computed tomography (LMCT) sinus score, according to study results presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2022 Annual Scientific Meeting, held November 10 to 14, 2022, in Louisville, Kentucky.

Patients with AERD represent a subgroup of those with CRSwNP. Researchers therefore sought to identify clinical screening markers to predict AERD in patients with CRSwNP.

The researchers conducted a retrospective, observational study of 177 patients with CRSwNP from January 1, 2016, to December 29, 2021. All patients had undergone desensitization, had clinically diagnosed AERD, or had undergone the aspirin challenge (AC), which the researchers described as “an effective diagnostic tool” for AERD. The researchers assessed baseline levels of serum EOS, basophils, immunoglobulins, complements, tryptase, LTE4, fractional exhaled nitric oxide, and LMCT scores.

Of the patients included, 42% were diagnosed with AERD. Among this group, 61 patients who denied nonsteroidal anti-inflammatory drug sensitivity completed the aspirin challenge, where results showed that 14 of these patients (23%) were positive for AERD.

Researchers determined LMCT scores, EOS, and LTE4 had a significant correlation with a positive aspirin challenge and that total complement activity (CH50) had a slight but significant negative trend with a positive aspirin challenge, although measurements were within normal range. No correlations were observed with the other markers investigated.

As study authors concluded, “Our data correlates AERD diagnosis with LMCT, EOS, LTE4 and CH50. Further studies are needed to confirm our CH50 results. These clinical, laboratory and radiologic markers could prove useful screening tools for identifying candidates for AC.”