Estimated Prevalence of AERD in Patients with Diagnosis of Asthma Identified with a Symptom-Based Assessment Questionnaire
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Ayobami Akenroye, MD MPH, Niharika Thota, MD, Rebecca Koransky, MD, Anna Tavdy, BA, Denisa Ferastraoaru, MD MSc, Elina Jerschow, M.D., M.Sc.
Rationale: The estimated prevalence of aspirin exacerbated respiratory disease (AERD) among asthma patients is 10-20%. There is no ICD-code for AERD. We sought to estimate AERD prevalence among asthma patients seen at Allergy, ENT, and Pulmonary Clinics at Montefiore Medical Center using a combination of specific diagnoses confirmed by a symptom-based questionnaire.

Methods: Patients seen between 2008-2013 with a combination of ICD-9 diagnoses of asthma, nonsteroidal anti-inflammatory drugs (NSAID) allergy, and either nasal polyps or chronic rhinosinusitis were identified. A questionnaire to assess AERD-related symptoms was administered via telephone.

Results: 4064 patients had ICD-9 diagnoses of asthma. Of these, 232 (7%) had ICD-9 diagnoses of NSAID allergy and either nasal polyps or chronic rhinosinusitis. One hundred forty-one patients agreed to participate in telephone interviews. The majority was female (82%), with mean age 52 (+/-SD 15). Sixty-five patients were categorized as “likely having AERD” based on reported asthma attacks with NSAID ingestion. The estimated AERD prevalence among asthma patients at Montefiore was 1.6%. Thirty-three patients (51%) with historically-diagnosed AERD reported frequent sinus infections, 31 patients (48%) had ≥1 sinus surgery, and 34 patients (54%) had poor or no sense of smell. Seventy-six patients reporting stomach pain, hives or angioedema, and no asthma symptoms after NSAID ingestion were identified as “not having AERD”

Conclusions: The estimated low AERD prevalence among patients with asthma indicates that AERD is not a simple combination of diagnoses and is likely underdiagnosed. Introducing AERD-specific ICD code could raise awareness about this condition and lead to appropriate treatment choices (aspirin desensitization).