N-ERD PROJECT 2020: PAVING THE FUTURE FOR BETTER AND COST-EFFECTIVE CARE FOR SEVERE CRSwNP PATIENTS (NERD)

The N-ERD project addresses 2 major unmet needs in the field of
chronic rhinosinusitis with nasal polyps (CRSwNP):
1/ the demonstration of the diagnostic value of aspirin nasal challenge
in patients with CRSwNP, as the under-diagnosis of aspirin intolerance
deprives these patients from an effective and safe treatment option
with lysin aspirin (LAS), and
2/ the demonstration of the efficacy of aspirin desensitisation in
CRSwNP patients using nasal lysin aspirin (LAS) or placebo drops for 12
months.
Patients with Non-Steroidal Anti-inflammatory Drug (NSAID)
Exacerbated Respiratory Disease (N-ERD) experience severe symptoms
at both end of the respiratory spectrum, i.e. CRSwNP and asthma, and
are often hospitalised for acute exacerbations of disease. Current
treatment options are limited to nasal and oral corticosteroids, oral
antibiotics in case of exacerbations, and sinus surgery. Up to 80% of NERD
patients remain uncontrolled as a consequence of severe sinonasal
and bronchial inflammation, and given the limited treatment options in
evidence-based guidelines. Nowadays, biological treatments are
emerging as attractive but very expensive novel treatment options for
N-ERD patients. However, personal experience at the University
Hospitals Leuven, as well as at the London Imperial College of Medicine
with nasal LAS drops drives this project application given the promising
outcomes and perspectives.
Time has come to conduct the first double-blinded, placebo-controlled,
randomised trial with nasal LAS drops in 2 leading centers in the field of
Rhinology and Allergology, i.e. University Hospitals Leuven and Imperial
College London. Both Peter Hellings (Leuven) and Guy Scadding
(London) have the ambition to engage into this N-ERD project that will
lead to a cheap, effective and patient-friendly approach patients with NERD.
Health care systems are waiting for effective, safe and cheap treatment
options that reduce exacerbations of diseas and costs of care.