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How to Manage Aspirin-Exacerbated Respiratory Disease

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Key Takeaways

  • AERD, or Samter’s triad, involves chronic inflammation affecting lungs and sinuses, often progressing from rhinitis to severe asthma.
  • Leukotrienes and type 2 inflammation are key drivers of AERD, influencing treatment strategies.
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This portion of the latest Lungcast episode includes a discussion of therapies, triggers, and management of AERD.

In the latest Lungcast episode, the topic of Aspirin-Exacerbated Respiratory Disease (AERD) was covered in an interview between host Albert Rizzo, MD, chief medical officer of the American Lung Association (ALA), Mitchell Grayson, MD, an allergist and immunologist from Nationwide Children’s Hospital, and patient advocates Rhonda and Wayne Nelson.

The episode featured a discussion of AERD, its characterization, treatment, and impacts on patients. In this segment of the episode, the 3 guests spoke with Rizzo about the management of the condition and therapies which may be useful.

“When we're talking about what is driving the disease, it tends to be more of the leukotrienes, which are associated with the [type 2 inflammation] model,” Grayson explained. “When we talk about therapy, actually treating for t2 diseases will work, so it fits within that context. But the actual mechanism of why you have the sensitivity to the [cyclooxygenase-1] inhibitors and stuff like that does not fit with a true t1 or t2-high, t2-low kind of model. I think that's kind of the difference [with asthma].”

AERD, also referred to as Samter’s triad, is a collection of chronic inflammatory conditions. The disorder, which affects the lungs and sinuses, is usually initiated with nasal symptoms or rhinitis and then frequently develops into more severe asthma and may require surgery. Grayson was asked by Rizzo about ways of addressing this condition as well as resources for patients with AERD.

“Asthma in general can be exacerbated by many environmental exposures, pollution, strong scents, and things like that,” Grayson noted. “So to try and understand what all those triggers are is an important piece of discussing care with your provider, in terms of what's available out there for people…The American Lung Association a wonderful website with all kinds of information about clean air as well as the impact on asthma. Other sites that you can go to as well. There's [also] several federal government sites. The EPA has good information on it. The National Heart Lung Blood Institute has a website as well that has good information about these environmental exposures.”

Over the course of this segment of the episode, information on the experiences patients have had in managing AERD were highlighted. Rhonda Nelson spoke on what her experiences had been in managing the condition as well as her own journey with treatment.

Lungcast is a monthly respiratory news podcast series hosted by Albert Rizzo, MD, chief medical officer of the ALA, and produced by HCPLive.

Subscribe to Lungcast on Spotify here, or listen to the episode below.

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