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Harvard Medical Schoolsearch Search HomeMission About AERD Aspirin Desensitization Research PATIENT REGISTRY – AERD/Samter’s Triad Patient Registry CLINICAL STUDY – MARINER study: Mechanisms of benefit of IL4Ra Inhibition in AERD Contact Us Search Search Submit What is AERD/Samter’s Triad? Aspirin Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad or Aspirin Sensitive Asthma, is a chronic medical condition that consists of asthma, recurrent sinus disease with nasal polyps, and a sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). Approximately 10% of all adults with asthma and 40% of patients with asthma and nasal polyps are sensitive to aspirin and NSAIDs. What are the symptoms? Patients with AERD/Samter’s Triad usually have asthma, nasal congestion, and nasal polyps, and often do not respond to conventional treatments. Many have experienced chronic sinus infections and can lose their sense of smell. The characteristic feature of AERD/Samter’s Triad is that patients develop reactions triggered by aspirin or other NSAIDs. These reactions can include: Increased nasal congestion or stuffiness Eye watering or redness Cough, wheezing, or chest tightness Frontal headache or sensation of sinus pain Flushing and/or a rash Nausea and/or abdominal cramping General feeling of malaise, sometimes accompanied by dizziness If you not do have asthma, nasal congestion and/or nasal polyps but experience reactions to aspirin or NSAIDs, click here and here to learn about the Brigham and Women’s Aspirin and NSAID Allergy Clinic. The Aspirin/NSAID Allergy new patient packet can be found here. Latest News & Information 19 Apr 24 Utilization of protocols to lower daily aspirin dose prior to surgical procedures for patients with AERD Aspirin-lowering and ibuprofen-bridging protocols are safe and effective for patients with aspirin-exacerbated respiratory disease to decrease aspirin dosing prior to elective surgical procedures, but were only utilized in half of surveyed participants, suggesting need for increased awareness. Click here to see our BWH aspirin-lowering protocol. Read more here. read more 03 Apr 24 Efficacy of various dosing frequencies of dupilumab in patients with AERD This study found that 32% of AERD patients on dupilumab for asthma or nasal polyposis had attempted a dosing interval other than every 2 weeks. Of those, 68% chose to continue with less frequent injections, most commonly every 3 weeks, without reduction in their perceived clinical benefit. Our data highlight the potential for patients with AERD to reduce their dupilumab dosing frequency in the future and the need for provider education about this option. Read more here . read more 26 Mar 24 Consequences of NSAID allergy on pain control options for patients with AERD This study demonstrates that celecoxib offers effective pain management for patients with AERD, and that non-selective NSAIDs (like ibuprofen and Naprosyn) are effective and safe for most AERD patients to take after aspirin desensitization. We found that there is a high rate of narcotic overprescribing for patients with AERD, suggesting that reported NSAID allergies predispose our patients to the use of stronger and potentially less safe pain medications. Interestingly, despite multiple studies pointing to celecoxib as an appropriate option for many patients with AERD, narcotics were more often prescribed for pain in place of a non-selective NSAID than was celecoxib. Additional education of our pain-management colleagues regarding the safety and efficacy of celecoxib in patients with AERD may help avoid unnecessary opioid over prescribing. Read more here. read more 03 Jan 24 Validation of a questionnaire assessing smell loss in an international aspirin-exacerbated respiratory disease population This study examined the validation of the questionnaires used for a prior study from our group that examined how loss of smell impacted the mental health and quality of life of patients with AERD . We determined that this new Consequences of Smell Loss (COSL) questionnaire can be used as a brief, valid, reliable tool that can effectively screen for a high burden of smell loss in patients with AERD and other patient populations where smell and olfaction are affected. Read more here. read more 13 Sep 23 Co-treatment of non-steroidal anti-inflammatory drug-exacerbated respiratory disease with dupilumab and aspirin therapy after desensitization In this study, we evaluated 22 patients with AERD who were treated with dupilumab for 3 months, and 8 of those patients had also undergone aspirin desensitization prior to the start of dupilumab and continued on their high-dose daily aspirin throughout the study. We found that treatment with dupilumab in patients who were also on daily aspirin therapy led to a reduction in sinonasal eosinophilic inflammation. We did not see a reduction in sinonasal eosinophilic inflammation in the patients who were only on dupilumab without the additional daily aspirin therapy. Conversely, we saw that patients who were only on the dupilumab did develop a significant increase in the eosinophil levels in their blood, but for the patients who were on daily aspirin therapy and then started dupilumab treatment, there was no significant change in their blood eosinophil levels after starting dupilumab. Both daily aspirin therapy after aspirin desensitization, and dupilumab therapy, have been important treatments for patients with AERD, and further studies may be needed to fully understand how these two treatment options work together. Read more here. read more 10 May 23 Trial of thromboxane receptor inhibition with ifetroban: TP receptors regulate eicosanoid homeostasis in aspirin-exacerbated respiratory disease This clinical trial compared one month of treatment with ifetroban (a medication that blocks the thromboxane A2 receptor) to placebo in patients with AERD, to see if the ifetroban treatment decreased the severity of aspirin-induced reactions. Unfortunately, there was a small signal that actually the treatment with ifetroban actually worsened patients’ reactions to aspirin. This was unexpected, and to further understand why, additional studies were done, that showed that ifetroban inhibited the production of prostaglandin E2 and increased the levels of cysteinyl leukotrienes, which likely explains why our patients had a negative response to it. Read more here read more 03 Oct 22 Pediatric-onset aspirin-exacerbated respiratory disease: Clinical characteristics, prevalence, and response to dupilumab AERD is generally recognized as an adult-onset disease, however; the prevalence of AERD in pediatric patients is not well defined. In May 2022 we described a series of 6 pediatric patients with AERD, and their childhood AERD symptoms were almost identical to those in adults with AERD. In our AERD registry we found that more than 6% of the patients report that their AERD symptoms started before 18 years of age and noted that females tend to develop AERD earlier than males, and that developing AERD as a child is more common for girls than for boys. Additionally, all 6 adolescent patients in this series had severe enough disease symptoms that they were prescribed dupilumab as a treatment option, and all of them had good responses to dupilumab with improvements in both asthma and sinus symptoms. Therefore, we recommend that for adolescents with poorly controlled symptoms of AERD the potential benefit of treatment with dupilumab should be considered. Read more here . read more 08 Sep 22 Loss of smell in patients with aspirin-exacerbated respiratory disease impacts mental health and quality of life A common problem for AERD patients is loss of sense of smell, or anosmia, but its impact on patients’ quality of life, mental health, and physical wellbeing has been poorly studied. We developed a new questionnaire about the consequences of anosmia, which, along with several other...