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Longitudinal progression of aspirin-exacerbated respiratory disease: analysis of a national insurance claims database.

Abstract：

BACKGROUND:Aspirin-exacerbated respiratory disease (AERD) is a recalcitrant inflammatory disorder defined by asthma, nasal polyposis, and sensitivity to cyclooxygenase-1 inhibitors. The timeline and course of disease progression is unclear. METHODS:The Truven MarketScan Database, a large American health insurance claims repository, was queried to identify patients meeting criteria for AERD from 2009 to 2015. Included patients had associated International Classification of Diseases, 9th edition (ICD-9) codes consistent with all 3 components of AERD: asthma, nasal polyposis, and drug allergy. Patterns of disease onset and time to progression were analyzed. RESULTS:A total of 5628 patients were identified for study inclusion. Of the 3 components of AERD, 3303 patients (59%) were initially diagnosed with asthma, 1408 (25%) were initially diagnosed with nasal polyps, and 917 (16%) were first diagnosed with drug sensitivity. The most common (36%) sequence of diagnoses was asthma, followed by nasal polyps, followed by drug allergy. The median interval between diagnosis of upper or lower airway involvement (ie, nasal polyps and/or asthma) to recognition of drug sensitivity was 259 days (quartiles Q1 to Q3: 92 to 603 days). In patients with both asthma and nasal polyps diagnoses, the risk of developing drug sensitivity during the study time period was 6%. CONCLUSION:Upper and lower airway disease is often initially recognized in patients with AERD, whereas drug sensitivity presents month to years later. This delay may be due to the pathophysiology of AERD and disease progression or due to practice patterns in diagnostic testing and coding. Further work is warranted to identify these patients at early stages in their disease progression.

journal_name

Int Forum Allergy Rhinol

journal_title

International forum of allergy & rhinology

authors

Roland LT,Wang H,Mehta CC,Cahill KN,Laidlaw TM,DelGaudio JM,Wise SK,Levy JM

doi

10.1002/alr.22412

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

1420-1423

issue

eissn

2042-6976

issn

2042-6984

journal_volume

pub_type

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Longitudinal progression of aspirin-exacerbated respiratory disease: analysis of a national insurance claims database.